NPIMap

Individual provider Active NPI

Jolly B Canlas, M.D.

  • Family Medicine Physician
  • Bethlehem, PA
National Provider Identifier
1558337030
Registry record updated Apr 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD033745E Issued in PA
Practice address
3897 Adler PL
Building C Suite 160
Bethlehem, PA 18017-9425
Phone
(610) 868-6830
Fax
(610) 868-4654
NPI assigned
Feb 24, 2006
Last updated
Apr 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD033745E PA Primary

Addresses

Primary practice location

3897 Adler PL
Building C Suite 160
Bethlehem, PA 18017-9425

Mailing address

3897 Adler PL
Building C Suite 160
Bethlehem, PA 18017-9425
Phone (610) 868-6830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060213000243 PA Practitioner - General PracticePractitioner - Family Practice 9234144205 Practice locations: Bethlehem, PA

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3897 Adler PL
Suite 160
Bethlehem, PA 18017-9425
Phone (610) 868-6830

3897 Adler Place
Suite 160
Bethlehem, PA 18017-9425

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Hospital & facility affiliations 11

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1558337030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3897 ADLER PL",
            "address_2": "BUILDING C SUITE 160",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179425",
            "telephone_number": "610-868-6830",
            "fax_number": "610-868-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3897 ADLER PL",
            "address_2": "BUILDING C SUITE 160",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180179425",
            "telephone_number": "610-868-6830",
            "fax_number": "610-868-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANLAS",
        "first_name": "JOLLY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD033745E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, PA

Sources for this page

Verify at the official NPI Registry.