Individual provider Active NPI

Dayana Alexandra Cannan, PA-C

  • Surgical Physician Assistant
  • Paterson, NJ
National Provider Identifier
1285940841
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00318800 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503
Phone
(862) 207-7510
Fax
(862) 257-1688
NPI assigned
Aug 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 25MP00318800 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503

Mailing address

254 Floral LN
Saddle Brook, NJ 07663-5041
Phone (973) 634-2336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140717000939 NJ Practitioner - Physician Assistant 0042455115 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

408 37TH St
Union City, NJ 07087-4994
Phone (201) 864-4477

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 379-5757

Hospital & facility affiliations

  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mehling Orthopedic of New York, PLLC Past Accepting new patients
St Marys General Medical Group PC Past Accepting new patients

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1285940841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 FLORAL LN",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635041",
            "telephone_number": "973-634-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07503",
            "telephone_number": "862-207-7510",
            "fax_number": "862-257-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNAN",
        "first_name": "DAYANA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-20",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00318800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.