Individual provider Active NPI

Alexander Ortman Canova, MD

  • Pediatric Cardiology Physician
  • Seattle, WA
National Provider Identifier
1588284244
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MD.MD.61408891 Issued in WA
Practice address
825 Eastlake Ave E
Seattle, WA 98109-4405
Phone
(206) 520-5000
NPI assigned
Apr 23, 2020
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD.MD.61408891 WA
Pediatric Cardiology Physician 2080P0202X MD.MD.61408891 WA Primary

Addresses

Primary practice location

825 Eastlake Ave E
Seattle, WA 98109-4405

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 987-3169

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260619001904 WA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 0244656106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

825 Eastlake Ave E
Seattle, WA 98109-4405

850 Republican St
Seattle, WA 98109-4725

PO Box
Suite 5371
Seattle, WA 98145

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61408891WAMDPediatric Cardiology Physician
31072MNMDPsychiatry Physician

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

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1588284244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EASTLAKE AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094405",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-3169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANOVA",
        "first_name": "ALEXANDER",
        "middle_name": "ORTMAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD.MD.61408891",
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "WA",
            "license": "MD.MD.61408891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.