Individual provider Active NPI

Erik M Canavan, PT

  • Physical Therapist
  • Liverpool, NY
National Provider Identifier
1356303077
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0172401 Issued in NY
Practice address
8390 Oswego Road
Liverpool, NY 13090-1002
Phone
(315) 652-4323
Fax
(315) 622-1110
NPI assigned
Apr 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0172401 NY Primary

Addresses

Primary practice location

8390 Oswego Road
Liverpool, NY 13090-1002

Mailing address

8390 Oswego Road
Liverpool, NY 13090-1002
Phone (315) 652-4323

Other identifiers 1

IdentifierTypeStateIssuer
02102770MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111103000864 NY Practitioner - Physical Therapist in Private Practice 2163695370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Physical Therapy LLCGroup PAC ID 5294702460, 12 clinicians

Practice addresses (Care Compare)

1054 James St
Syracuse, NY 13203-2749
Phone (315) 422-2912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017240NYMDMental Health Counselor
17240NYMDCase Manager/Care Coordinator
0172401NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Physical Therapy LLC Physical Therapist CurrentSince Dec 16, 2023 Accepting new patients

Locations

4136 State Route 31
Clay, NY 13041

1054 James St
Syracuse, NY 13203
Phone (315) 422-2912

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356303077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 OSWEGO ROAD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901002",
            "telephone_number": "315-652-4323",
            "fax_number": "315-622-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 OSWEGO ROAD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130901002",
            "telephone_number": "315-652-4323",
            "fax_number": "315-622-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "ERIK",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0172401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02102770",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liverpool, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.