Johnny C Canciller, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

17751 Issued in CA

Practice address

10234 Rosecrans Ave
Bellflower, CA 90706-2602

Phone

(562) 920-1692

Fax

(562) 920-4643

NPI assigned

Mar 25, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.61 of 100Reported as group

Quality

58.7

Improvement activities

40

Cost

75.08

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment Care Compare group
• Pih Health Physicians

  • Family Medicine Physician
  • Whittier, CA
  • NPI 1609233899
  Medicare reassignment
• Pioneer Medical Group Inc.

  • Multi-Specialty Clinic/Center
  • Bellflower, CA
  • NPI 1548303589
  Medicare reassignment
• Pih Health Physicians

  • Family Medicine Physician
  • Downey, CA
  • NPI 1265951099
  NPD
• Pih Health Physicians

  • Anesthesiology Physician
  • Downey, CA
  • NPI 1447931506
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1134151657
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1508038043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMITTANCE DR DEPT 6008",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606756008",
            "telephone_number": "562-282-1419",
            "fax_number": "562-920-4642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10234 ROSECRANS AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907062602",
            "telephone_number": "562-920-1692",
            "fax_number": "562-920-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCILLER",
        "first_name": "JOHNNY",
        "middle_name": "C",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-25",
        "last_updated": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA 17751",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "17751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gabriel Calzada, MD
• Ador Zuniga Camiling, D.D.S.
• Daisy Campos Linser
• Karinnete Campos
• Natalie Adriana Campos
• Michelle Candido, PHARM.D.
• Emer Cabance Canteras, RN
• Hanh Ly Cao
• Car & Mar Holdings LLC
• Rosie Carbajal, NP

• Physician Assistant in Bellflower, CA
• Providers in Bellflower, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.