Active NPI
Rebecca Canna, PSY.D.
- Psychologist
- Philadelphia, PA
National Provider Identifier
1184886566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS016417
- Practice address
- 1225 Vine St
3Rd Floor
Philadelphia, PA 19107-1116 - Phone
- (215) 304-0680
- NPI assigned
- Jun 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS016417 | PA | Primary |
Addresses
Primary practice location
1225 Vine St
3Rd Floor
Philadelphia, PA 19107-1116
Mailing address
211 Lazaretto Rd
12 G
Prospect Park, PA 19076-1835
Phone (610) 304-0680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3855 W Chester Pike
Suite 300
Newtown Square, PA 19073-2304
Phone (484) 427-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS016417 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Main Line Affiliates | Psychologist | Past | Accepting new patients |
| Rla Assessment and Consultation LLC | Psychologist | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Newtown Square, PA
- NPI 1922077643
-
- Psychologist
- Philadelphia, PA
- NPI 1619835360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214524800000",
"number": "1184886566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 LAZARETTO RD",
"address_2": "12 G",
"city": "PROSPECT PARK",
"state": "PA",
"postal_code": "190761835",
"telephone_number": "610-304-0680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 VINE ST",
"address_2": "3RD FLOOR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191071116",
"telephone_number": "215-304-0680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNA",
"first_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-27",
"last_updated": "2008-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS016417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.