Corliss Kanazawa

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

432513 Issued in NY

Practice address

462 1St Ave
New York, NY 10016-9196

Phone

(212) 562-4141

NPI assigned

Nov 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• New York City Health and Hospitals Corporation

  dba Jacobi Medical Center

  • General Acute Care Hospital
  • Bronx, NY
  • NPI 1679587679
  NPD (past)

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1194435677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BCD 556, 550 FIRST AVE. BELLEVUE HOSPITAL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAZAWA",
        "first_name": "CORLISS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "432513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anxhela Kanani
• Krutika Kanani
• Alexandra Marie Kanapes
• Deborah Karmel Kanarfogel, OD
• Yuliya Kanatova, D.D.S
• Mizuho Kanazawa, LCAT, MA-RDT, CCLS
• Rania Lee K Kanazi
• Pushpa L Kancherla, M.D.
• Marc Kanchuger, M.D.
• Emanuel Kand, DDS

• Acute Care Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Acute Care Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.