Individual provider Active NPI

George A Cancel, M.D., M.H.A.

  • Emergency Medicine Physician
  • Elkhart, IN
National Provider Identifier
1679645642
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
017481 Issued in ME
Practice address
600 East Blvd
Elkhart, IN 46514-2483
Phone
(207) 795-0111
Fax
(207) 753-7201
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 017481 ME Primary

Addresses

Primary practice location

600 East Blvd
Elkhart, IN 46514-2483

Mailing address

PO Box 1241
South Bend, IN 46624-1241
Phone (855) 691-9888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20161003000937 IN Practitioner - Emergency Medicine 4385643279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Massachusetts Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Bend Emergency Physicians IncGroup PAC ID 0941282354, 51 clinicians

Practice addresses (Care Compare)

615 N Michigan St
South Bend, IN 46601-1033
Phone (574) 647-1000

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017481MEMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Bend Emergency Physicians, Inc Emergency Medicine CurrentSince Sep 1, 2023 Accepting new patients
Elite Emergency Physicians Inc Emergency Medicine CurrentSince Oct 1, 2016 Accepting new patients

Locations

1020 High Rd
Bremen, IN 46506
Phone (574) 309-9967

600 East Blvd
Elkhart, IN 46514
Phone (574) 294-2621

3220 Beacon Pkwy
Granger, IN 46530
Phone (574) 647-8788

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

Interoperability endpoints

  • Direct secure messaging: gcancel144699@direct.trinity-health.org

Organizations & group practices 2

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 4

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1679645642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1241",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466241241",
            "telephone_number": "855-691-9888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "207-795-0111",
            "fax_number": "207-753-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCEL",
        "first_name": "GEORGE",
        "middle_name": "A",
        "credential": "M.D., M.H.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "017481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.