NPIMap

Individual provider Active NPI

Cheryl A Canto, M.D.

  • Family Medicine Physician
  • Port Huron, MI
National Provider Identifier
1164423216
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301066771 Issued in MI
Practice address
2540 16TH St
Port Huron, MI 48060-6405
Phone
(810) 987-1000
Fax
(810) 982-1810
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301066771 MI Primary

Addresses

Primary practice location

2540 16TH St
Port Huron, MI 48060-6405

Mailing address

2540 16TH St
Port Huron, MI 48060-6405
Phone (810) 987-1000

Other identifiers 1

IdentifierTypeStateIssuer
4711753MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031124000298 MI Practitioner - Family Practice 2062316896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Port Huron Internal Medicine AssociatesGroup PAC ID 2567497910, 5 clinicians

Practice addresses (Care Compare)

2540 16TH St
Port Huron, MI 48060-6405
Phone (810) 987-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301066771MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Port Huron Internal Medicine Associates Family Medicine CurrentSince Jul 6, 2011 Accepting new patients
Port Huron Internal Medicine PastSince Jul 6, 2011 Accepting new patients
Regency on the Lake-Fort Gratiot, LLC Past Accepting new patients

Locations

2540 16th St
Port Huron, MI 48060
Phone (810) 987-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: cheryl.canto.p1@direct.phim.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Regency on the Lake-Fort GratiotFort Gratiot, MI, CCN 235621 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1164423216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 16TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606405",
            "telephone_number": "810-987-1000",
            "fax_number": "810-982-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 16TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606405",
            "telephone_number": "810-987-1000",
            "fax_number": "810-982-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTO",
        "first_name": "CHERYL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301066771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4711753",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.