Individual provider Active NPI

Felicia A Canada, MD

  • Family Medicine Physician
  • Bradenton, FL
National Provider Identifier
1619928231
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME88134 Issued in FL
Practice address
11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone
(941) 907-6016
Fax
(941) 907-0199
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 ME88134 FL Primary

Addresses

Primary practice location

11505 Rangeland Pkwy
Bradenton, FL 34211-4041

Mailing address

11505 Rangeland Pkwy
Bradenton, FL 34211-4041
Phone (941) 907-6016

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Felicia.Canada@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

17470 Brookside Trace CT
Tampa, FL 33647-6201
Phone (813) 443-5042

Hospital & facility affiliations

  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087
  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME88134FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc Family Medicine CurrentSince Dec 1, 2010 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Tri Hospital MRI Center Past Accepting new patients

Locations

11505 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 907-6016

11505 Rangeland Pkwy
Fl 2
Bradenton, FL 34211

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

921 S Beneva Rd
Sarasota, FL 34232
Phone (941) 365-7390

Interoperability endpoints

  • Direct secure messaging: felicia.canada@img.directbygreenway.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1619928231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-907-6016",
            "fax_number": "941-907-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11505 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114041",
            "telephone_number": "941-907-6016",
            "fax_number": "941-907-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "FELICIA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME88134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Felicia.Canada@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11505 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342114041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.