Individual provider Active NPI

Elda Marie Canabal, MSA

  • Audiologist-Hearing Aid Fitter
  • San Juan, PR
National Provider Identifier
1225201692
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
508 Issued in PR
Practice address
356 Calle Ensenada
San Juan, PR 00920-3501
Phone
(787) 781-3055
Fax
(787) 781-4008
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 508 PR Primary

Addresses

Primary practice location

356 Calle Ensenada
San Juan, PR 00920-3501

Mailing address

PO Box 11927
San Juan, PR 00922-1927
Phone (787) 781-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140625001073 PR Practitioner - Qualified Audiologist 1557586062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Puerto Rico School of Medicine, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

356 Calle Ensenada
San Juan, PR 00920-3501
Phone (787) 781-3055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Audifonos Audio Centro Inc Audiologist-Hearing Aid Fitter CurrentSince May 6, 2014 Accepting new patients

Locations

356 Calle Ensenada
San Juan, PR 00920
Phone (787) 781-3055

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1225201692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11927",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009221927",
            "telephone_number": "787-781-3055",
            "fax_number": "787-781-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 CALLE ENSENADA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009203501",
            "telephone_number": "787-781-3055",
            "fax_number": "787-781-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANABAL",
        "first_name": "ELDA",
        "middle_name": "MARIE",
        "credential": "MSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PR",
            "license": "508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.