Individual provider Active NPI

Caleb John Cannella, CAA

  • Anesthesiologist Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1346960929
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA741 Issued in FL
Practice address
1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831
Phone
(800) 437-2672
NPI assigned
Sep 1, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA741 FL Primary

Addresses

Primary practice location

1525 W Cypress Creek Rd
Fort Lauderdale, FL 33309-1831

Mailing address

6451 Pershing St
Hollywood, FL 33024-2036
Phone (850) 597-0753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220920001758 FL Practitioner - Anesthesiology Assistant 3870978364 Reassigns benefits to 2 organizations
I20260514003682 GA Practitioner - Anesthesiology Assistant 3870978364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp Inc 956 clinicians

Practice addresses (Care Compare)

1431 SW 1St Ave
Ocala, FL 34471-6500
Phone (352) 401-1033

Hospital & facility affiliations

  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038
  • Broward Health Imperial Point Hospital, Fort Lauderdale, FL, CCN 100200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA741FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Associates of Tallahassee, Inc. Anesthesiologist Assistant CurrentSince Jan 1, 2023 Accepting new patients
Sheridan Healthcorp Inc CurrentSince Sep 1, 2022 Accepting new patients
Sheridan Healthcorp Inc Current Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Anesthesiology Associates of Tallahassee Inc CurrentSince Jan 1, 2023 Accepting new patients
Anesthesiology Associates of Tallahassee Inc Past Accepting new patients

Locations

1431 SW 1st Ave
Ocala, FL 34471
Phone (352) 401-1425

333 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 584-0643

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

2173 Centerville Pl
Ste A
Tallahassee, FL 32308

2629 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 877-4688

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1346960929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 PERSHING ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242036",
            "telephone_number": "850-597-0753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 W CYPRESS CREEK RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333091831",
            "telephone_number": "800-437-2672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNELLA",
        "first_name": "CALEB",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.