Individual provider Active NPI

Karen M Canellas Correa, M.D.

  • General Practice Physician
  • Gurabo, PR
National Provider Identifier
1235201773
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
16245 Issued in PR
Practice address
168 Calle Cundiamor
Ciudad Jardin Gurabo
Gurabo, PR 00778-9720
Phone
(787) 627-7781
NPI assigned
Nov 13, 2006
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 16245 PR Primary
Family Medicine Physician 207Q00000X 16245 PR

Addresses

Primary practice location

168 Calle Cundiamor
Ciudad Jardin Gurabo
Gurabo, PR 00778-9720

Mailing address

168 Calle Cundiamor
Ciudad Jardin de Gurabo
Gurabo, PR 00778-9720
Phone (787) 627-7781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120911000691 PR Practitioner - General PracticePractitioner - Family Practice 7012165327 Reassigns benefits to 3 organizations
Practice locations: Juncos, PR

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Domiciliary Care Organization of Puerto Rico General Practice CurrentSince Aug 3, 2022 Accepting new patients
Doctor House, Inc CurrentSince Jun 1, 2020 Accepting new patients

Locations

49 Calle Munoz Rivera
Juncos, PR 00777
Phone (787) 561-0107

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1235201773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 CALLE CUNDIAMOR",
            "address_2": "CIUDAD JARDIN DE GURABO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007789720",
            "telephone_number": "787-627-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 CALLE CUNDIAMOR",
            "address_2": "CIUDAD JARDIN GURABO",
            "city": "GURABO",
            "state": "PR",
            "postal_code": "007789720",
            "telephone_number": "787-627-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANELLAS CORREA",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "16245",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "16245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurabo, PR

Sources for this page

Verify at the official NPI Registry.