Active NPI
Elizabeth Jean Canoni, PT, DPT
- Orthopedic Physical Therapist
- Malden, MA
National Provider Identifier
1689664898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 11243
- Practice address
- 388 Pleasant St
Suite 203
Malden, MA 02148-8143 - Phone
- (781) 388-0012
- Fax
- (781) 388-3312
- NPI assigned
- Oct 27, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 11243 | MA | Primary |
Addresses
Primary practice location
388 Pleasant St
Suite 203
Malden, MA 02148-8143
Mailing address
88 Converse LN
Melrose, MA 02176-5121
Phone (781) 632-5202
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y67615 | Other | MA | BCBS PROVIDER NUMBER |
| 468857 | Other | MA | TUFTS PROVIDER NUMBER |
| AA38236 | Other | MA | HARVARD PILGRIM NUMBER |
Other names 1
- Elizabeth Jean Dodge
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accord Management Services Inc | Orthopedic | Past | Accepting new patients |
| Tim Dreher PT & Associates, Inc. | Orthopedic | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689664898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 CONVERSE LN",
"city": "MELROSE",
"state": "MA",
"postal_code": "021765121",
"telephone_number": "781-632-5202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "388 PLEASANT ST",
"address_2": "SUITE 203",
"city": "MALDEN",
"state": "MA",
"postal_code": "021488143",
"telephone_number": "781-388-0012",
"fax_number": "781-388-3312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANONI",
"first_name": "ELIZABETH",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MA",
"license": "11243",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "Y67615",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS PROVIDER NUMBER",
"identifier": "468857",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM NUMBER",
"identifier": "AA38236",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "DODGE",
"middle_name": "JEAN",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Malden, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.