Individual provider Active NPI

Miguela A Caniza, MD

  • Pediatric Infectious Diseases Physician
  • Memphis, TN
National Provider Identifier
1790788990
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
29297 Issued in TN
Practice address
262 Danny Thomas PL
Memphis, TN 38105-3678
Phone
(901) 595-3006
Fax
(901) 595-3842
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 29297 TN Primary

Addresses

Primary practice location

262 Danny Thomas PL
Memphis, TN 38105-3678

Mailing address

262 Danny Thomas PL
Ms 515
Memphis, TN 38105-3678
Phone (901) 595-3006

Other identifiers 15

IdentifierTypeStateIssuer
00124592MedicaidMS
1106674MedicaidLA
205358401MedicaidMO
0547141MedicaidIA
145066001MedicaidAR
200341290AMedicaidIN
422400000MedicaidME
100011140AMedicaidOK
177330101MedicaidTX
3899243MedicaidTN
64037997MedicaidKY
1165135 00MedicaidWY
0076023MedicaidNJ
009964160MedicaidAL
7614121MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20220628002662 TN Practitioner - Pediatric Medicine 9537309158 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29297TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Jude Children'S Research Hospital, Inc. CurrentSince Feb 19, 2022 Accepting new patients

Locations

262 Danny Thomas Pl
Memphis, TN 38105
Phone (888) 226-4343

262 Danny Thomas Pl
#515
Memphis, TN 38105
Phone (901) 495-3006

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1790788990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "address_2": "MS 515",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3006",
            "fax_number": "901-595-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 DANNY THOMAS PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381053678",
            "telephone_number": "901-595-3006",
            "fax_number": "901-595-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANIZA",
        "first_name": "MIGUELA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TN",
            "license": "29297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00124592",
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        },
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            "identifier": "1106674",
            "state": "LA"
        },
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            "code": "05",
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        },
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            "state": "IA"
        },
        {
            "code": "05",
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            "identifier": "145066001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200341290A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422400000",
            "state": "ME"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "100011140A",
            "state": "OK"
        },
        {
            "code": "05",
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            "identifier": "177330101",
            "state": "TX"
        },
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            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3899243",
            "state": "TN"
        },
        {
            "code": "05",
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            "identifier": "64037997",
            "state": "KY"
        },
        {
            "code": "05",
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            "identifier": "1165135 00",
            "state": "WY"
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "0076023",
            "state": "NJ"
        },
        {
            "code": "05",
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            "identifier": "009964160",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7614121",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.