John Buckley Canalizo, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME67318 Issued in FL

Practice address

1055 Saxon Blvd
Orange City, FL 32763-8468

Phone

(386) 943-4522

NPI assigned

May 27, 2006

Last updated

Aug 3, 2009By the provider in NPPES

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of South Florida College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primecare at Twin Lakes LLCGroup PAC ID 3072591924, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primecare at Twin Lakes LLC

  • Urgent Care Clinic/Center
  • Daytona Beach, FL
  • NPI 1902809122
  Medicare reassignment Care Compare group NPD
• Primecare Acquisition Family Practice Inc

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1003452681
  Medicare reassignment NPD
• Bay View Urgent Care LLC

  • Family Medicine Physician
  • New Smyrna Beach, FL
  • NPI 1386896991
  NPD (past)
• Halifax Healthcare Systems Inc

  dba HHCSI Halifax Family Health Center

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1245283530

  Emergency Medicine

  NPD (past)
• Primecare at Twin Lakes LLC

  dba PrimeCare Urgent Care Centers

  • Urgent Care Clinic/Center
  • New Smyrna Beach, FL
  • NPI 1104072594
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1538116355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9430",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209430",
            "telephone_number": "386-274-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 SAXON BLVD",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638468",
            "telephone_number": "386-943-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANALIZO",
        "first_name": "JOHN",
        "middle_name": "BUCKLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME67318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250628900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "32396",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rene Cabeza, MD
• Ryann Cahill
• Calm Corner Therapy LLC
• Crystal Dawn Campbell, LCSW
• Lilly Anna Canalejo
• Alfred H Cann III, O.D.
• Rene Capulong, MD
• Care Life Outreach Inc. (A Plus Medical)
• Carenow Pharmacy LLC
• Carepack Pharmacy LLC

• Emergency Medicine Physician in Orange City, FL
• Providers in Orange City, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.