Marco Valerio Canulla, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

38460 Issued in OK

Practice address

14044 W Camelback Rd Ste 118
Litchfield Park, AZ 85340-9481

Phone

(623) 584-4882

Fax

(623) 584-6732

NPI assigned

Dec 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

University of Arkansas College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

NV Surgicalist PLLCGroup PAC ID 5698166387, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elements of Elder Care LLC Hospice, Phoenix, AZ, CCN 031721
• Supportive Hands Hospice Inc Hospice, Phoenix, AZ, CCN 001527
• True Heart Hospice LLC Hospice, Temple, TX, CCN 741744
• Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
• Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcanulla1183069@directc.mercy.net

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

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

• Elements of Elder Care

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1821617960

  Contracted Managing Employee

  CMS ownership
• Supportive Hands Hospice Inc

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1700554516

  Operational/Managerial Control

  CMS ownership

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.

• Mercy Clinic Oklahoma Communities

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1386874550
  Medicare reassignment Care Compare group NPD
• NV Surgicalist PLLC

  • Surgery Physician
  • Las Vegas, NV
  • NPI 1578229456
  Medicare reassignment Care Compare group NPD
• Compassionate Surgical Care, LLC

  • Surgery Physician
  • Scottsdale, AZ
  • NPI 1912589656
  NPD Authorized official

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

• Elements of Elder Care

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1821617960
  Care Compare affiliation
• Supportive Hands Hospice Inc

  • Community Based Hospice Care Agency
  • Phoenix, AZ
  • NPI 1700554516
  Care Compare affiliation
• Mercy Hospital Oklahoma City, Inc

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1184721722
  Care Compare affiliation
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1104870187
  Care Compare affiliation
• True Heart Hospice LLC

  • Community Based Hospice Care Agency
  • Temple, TX
  • NPI 1376058925
  Care Compare affiliation

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1194700286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21647",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336221647",
            "telephone_number": "405-696-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14044 W CAMELBACK RD STE 118",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409481",
            "telephone_number": "623-584-4882",
            "fax_number": "623-584-6732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 E Orangewood Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850205130",
            "country_code": "US",
            "telephone_number": "602-535-8200",
            "fax_number": "602-457-2517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2728 N 24th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850081050",
            "country_code": "US",
            "telephone_number": "602-535-8200",
            "fax_number": "602-457-2517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANULLA",
        "first_name": "MARCO",
        "middle_name": "VALERIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "38460",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "24230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "348583",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee D Caldwell, DVM
• Brianna Callahan, RBT
• Justin Patrick Campagna, MD
• Connie L. Canada, LM
• Jaclyn Cano
• Careco LLC Dba Right at Home
• Keri Cariaga, C.O.T.A.
• Madeline P Carlino, MS, BCBA
• Cecilia Carlson
• Gabriella M Carnero, RBT

• Surgery Physician in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.

Verify at the official NPI Registry.