Individual provider Active NPI

Michelle Canarick

  • Physician Assistant
  • Woodbury, NY
National Provider Identifier
1699408062
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
80 Christopher CT
Woodbury, NY 11797-1249
Phone
(516) 398-9290
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

80 Christopher CT
Woodbury, NY 11797-1249

Mailing address

80 Christopher CT
Woodbury, NY 11797-1249
Phone (516) 398-9290

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027001704 NY Practitioner - Physician Assistant 0749657153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

111 Broadway
FL 2
New York, NY 10006-1995
Phone (212) 263-9701

1465 3Rd Ave
New York, NY 10028-1926
Phone (646) 754-2300

171 Delancey St
New York, NY 10002-3411
Phone (929) 455-2600

333 E 38TH St
New York, NY 10016-2772
Phone (646) 356-9400

355 W 52ND St
New York, NY 10019-6239
Phone (646) 778-5555

97 Amity St
Brooklyn, NY 11201-6004
Phone (212) 598-6784

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214
  • Rusk Rehabilitation Inpatient rehabilitation facility, New York, NY, CCN 33T214

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
028781NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Single Specialty CurrentSince Sep 6, 2022 Accepting new patients
New York University CurrentSince Sep 6, 2022 Accepting new patients

Locations

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Interoperability endpoints

  • Direct secure messaging: mcanarick453971@nyumc.direct-ci.com

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 9

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1699408062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 CHRISTOPHER CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971249",
            "telephone_number": "516-398-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 CHRISTOPHER CT",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971249",
            "telephone_number": "516-398-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANARICK",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

Verify at the official NPI Registry.