Individual provider Active NPI

Gina M Canen, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Beacon, NY
National Provider Identifier
1801064282
Registry record updated Mar 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F406391-01 Issued in NY
Practice address
41 Verplanck Ave
Beacon, NY 12508-1844
Phone
(908) 798-0326
NPI assigned
Feb 19, 2008
Last updated
Mar 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F406391-01 NY Primary

Addresses

Primary practice location

41 Verplanck Ave
Beacon, NY 12508-1844

Mailing address

41 Verplanck Ave
Beacon, NY 12508-1844
Phone (718) 828-2666

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
I20250116003528 NY Order and Referring Only - Nurse Practitioner 2163950221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F406391-01NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741478400000",
    "number": "1801064282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 VERPLANCK AVE",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125081844",
            "telephone_number": "718-828-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 VERPLANCK AVE",
            "city": "BEACON",
            "state": "NY",
            "postal_code": "125081844",
            "telephone_number": "908-798-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANEN",
        "first_name": "GINA",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2025-03-09",
        "certification_date": "2025-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F406391-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beacon, NY

Sources for this page

Verify at the official NPI Registry.