NPIMap

Individual provider Active NPI

Gloria M Canizales, D.O.

  • Family Medicine Physician
  • Hamburg, NJ
National Provider Identifier
1295173185
Registry record updated Nov 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB09756500 Issued in NJ
Practice address
225 Route 23 North
Hamburg, NJ 07419
Phone
(973) 209-1550
Fax
(973) 209-4832
NPI assigned
Jun 12, 2013
Last updated
Nov 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0 NU
Family Medicine Physician 207Q00000X 25MB09756500 NJ Primary

Addresses

Primary practice location

225 Route 23 North
Hamburg, NJ 07419

Mailing address

532 Lafayette Rd
Suite 300
Sparta, NJ 07871-4411
Phone (973) 940-0423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160801002180 NJ Practitioner - Family Practice 7012200876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rowan University School of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Associates LLCGroup PAC ID 0840283008, 45 clinicians

Practice addresses (Care Compare)

123 Newton Sparta Rd
Newton, NJ 07860-2769
Phone (973) 579-6300

225 State Route 23
Suite 1C
Hamburg, NJ 07419-1704
Phone (973) 383-1450

715 Route 10 E
Randolph, NJ 07869-2025
Phone (973) 343-7040

89 Sparta Ave
Sparta, NJ 07871-1777
Phone (973) 209-1550

89 Sparta Ave
Suite 100
Sparta, NJ 07871-1790
Phone (973) 729-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.05 of 100Reported as apm
Quality
65.09
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Associates LLC CurrentSince Jul 1, 2016 Accepting new patients
Premier Health Associates, LLC CurrentSince Jul 1, 2016 Accepting new patients
Healing Touch Physical Therapy Center LLC Past Accepting new patients

Locations

225 State Rt 23 S
Ste 1C
Hamburg, NJ 07419
Phone (973) 209-1550

123 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 579-1000

532 Lafayette Rd
Ste 300
Sparta, NJ 07871
Phone (973) 940-0423

Interoperability endpoints

  • Direct secure messaging: gloriacanizales@premiernj.allscriptsdirect.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJHBA

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.

Hospital & facility affiliations 6

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": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478131200000",
    "number": "1295173185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 LAFAYETTE RD",
            "address_2": "SUITE 300",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714411",
            "telephone_number": "973-940-0423",
            "fax_number": "973-940-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ROUTE 23 NORTH",
            "city": "HAMBURG",
            "state": "NJ",
            "postal_code": "07419",
            "telephone_number": "973-209-1550",
            "fax_number": "973-209-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANIZALES",
        "first_name": "GLORIA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-12",
        "last_updated": "2016-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": "0",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09756500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NJ

Sources for this page

Verify at the official NPI Registry.