Martin Canavan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

010239 Issued in NY

Practice address

4700 Onondaga Blvd
Syracuse, NY 13219-3316

Phone

(315) 475-7121

Fax

(315) 475-7144

NPI assigned

Aug 12, 2005

Last updated

May 13, 2008By 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 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Achieve Physical Therapy, PCGroup PAC ID 0749186971, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Achieve Physical Therapy, PC

  • Physical Therapist
  • Syracuse, NY
  • NPI 1790778983
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210636800000",
    "number": "1619979341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "SUITE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-472-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 ONONDAGA BLVD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132193316",
            "telephone_number": "315-475-7121",
            "fax_number": "315-475-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAVAN",
        "first_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2008-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02461672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Campoverde
• Robert Paul Camuglia, DDS
• Aliz'E Canada
• Gabriela Canal, PA
• Ann Cathryn Canastra, MS, NCC
• Michelle L Canavan, LMSW
• Timothy Patrick Canavan, MD
• Nicole Candiotti
• Allison Canfield, PHD
• David C Canfield, MD

• Physical Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.