Individual provider Active NPI

Krizelle Viray Canzanese, PT

  • Physical Therapist
  • Las Cruces, NM
National Provider Identifier
1699377242
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5276 Issued in NM
Practice address
1350 Hillrise Cir
Las Cruces, NM 88011-4759
Phone
(575) 522-9500
NPI assigned
Nov 9, 2020
Last updated
Feb 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5276 NM Primary

Addresses

Primary practice location

1350 Hillrise Cir
Las Cruces, NM 88011-4759

Mailing address

7024 Chaco St
Las Cruces, NM 88012-0826
Phone (407) 257-6648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230203001352 NM Practitioner - Physical Therapist in Private Practice 1759753551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Wellness Center LLCGroup PAC ID 2668853128, 2 clinicians

Practice addresses (Care Compare)

2170 E Lohman Ave
Suite C
Las Cruces, NM 88001-8440
Phone (575) 449-7002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Physical Therapy & Wellness Center LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

2170 E Lohman Ave
Ste C
Las Cruces, NM 88001
Phone (570) 449-7002

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1699377242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7024 CHACO ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880120826",
            "telephone_number": "407-257-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HILLRISE CIR",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114759",
            "telephone_number": "575-522-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANZANESE",
        "first_name": "KRIZELLE",
        "middle_name": "VIRAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.