Peter Paul Cannava, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

516 Issued in AK

Practice address

230 E Marydale Ave
Suite 1
Soldotna, AK 99669-7648

Phone

(907) 260-3691

Fax

(907) 260-7301

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peninsula Community Health Services of Alaska Inc 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEIFAA

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.

• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Soldotna, AK
  • NPI 1700984614

  AK

  Medicare reassignment Care Compare group NPD
• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kenai, AK
  • NPI 1659825776
  Care Compare group NPD
• Peninsula Community Health Services of Alaska, Inc.

  • Community/Behavioral Health Agency
  • Soldotna, AK
  • NPI 1124110796
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1508997867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2949",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996692949",
            "telephone_number": "907-260-7300",
            "fax_number": "907-260-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E MARYDALE AVE",
            "address_2": "SUITE 1",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996697648",
            "telephone_number": "907-260-3691",
            "fax_number": "907-260-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNAVA",
        "first_name": "PETER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AK",
            "license": "516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FH177FQ",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH0156",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zetta Byrd, RN
• Charles Caburnay
• Robert E Cadoff, M.D.
• Mathew M Cannava, M.D.
• Peter E Cannava, MD
• Caring Hand in Hand Human Services LLC
• Whitney Carlson, NP
• Nicole E Carlyle
• Thomas D Carmichael
• Chelsey Carter

• All providers in Soldotna, AK
• Psychologist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; 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.