Jerrold S. Canakis, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

D0059594 Issued in MD

Practice address

10344 Old Ocn Blvd
Berlin, MD 21811

Phone

(410) 641-2938

Fax

(410) 641-4904

NPI assigned

Oct 11, 2005

Last updated

Aug 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Gastroenterology

Education

Temple University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Beebe Medical Center Hospital, Lewes, DE, CCN 080007
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

Merit-based Incentive Payment System (MIPS)

Final score

82.92 of 100Reported as group

Quality

74.47

Promoting interoperability

92

Improvement activities

40

Cost

75.27

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jerroldcanakis@agh.allscriptsdirect.net

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.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Tidalhealth Peninsula Regional, Inc.

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1184832040

  Gastroenterology

  Medicare reassignment NPD
• Jerrold S. Canakis, MD PA

  • Gastroenterology Physician
  • Berlin, MD
  • NPI 1528241171
  Authorized official Same address or phone
• Tidalhealth Peninsula Regional, Inc.

  dba TidalHealth Specialty Pharmacy

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1871031559
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation
• Beebe Medical Center, Inc.

  • General Acute Care Hospital
  • Lewes, DE
  • NPI 1821196486
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1700874179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10344 OLD OCN BLVD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "21811",
            "telephone_number": "410-641-2938",
            "fax_number": "410-641-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAKIS",
        "first_name": "JERROLD",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "DE",
            "license": "C10006596",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0059594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400997500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cambridge Physical Therapy, LLC (Pivot Physical Therapy)
• Alexandria Shareen Camper
• Betsy Kane Carpenter, LCPC
• Lori E. Carrick
• Kieran Carrier
• Lori Carson, LCPC
• Daniel Carter

• Gastroenterology Physician in Berlin, MD
• Providers in Berlin, MD by specialty
• Gastroenterology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.