Individual provider Active NPI

Monique Canada, MPA, CHES

  • Health Educator
  • Middletown, NY
National Provider Identifier
1629723150
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
33110 Issued in NY
Practice address
7 Wilcox Ave
Middletown, NY 10940-4911
Phone
(917) 334-9462
NPI assigned
Feb 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X 33110 NY Primary

Addresses

Primary practice location

7 Wilcox Ave
Middletown, NY 10940-4911

Mailing address

7 Wilcox Ave
Middletown, NY 10940-4911
Phone (917) 334-9462

Other identifiers 1

IdentifierTypeStateIssuer
33110OtherNYCHES ID

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Middletown Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
33110NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1629723150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WILCOX AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404911",
            "telephone_number": "917-334-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 WILCOX AVE",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109404911",
            "telephone_number": "917-334-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "MONIQUE",
        "credential": "MPA, CHES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NY",
            "license": "33110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHES ID",
            "identifier": "33110",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Middletown",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Middletown",
            "address_1": "7 Wilcox Ave",
            "city": "Middletown",
            "state": "NY",
            "country_code": "US",
            "postal_code": "109404911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.