Individual provider Active NPI

John B Dacanay, MD

  • Obstetrics & Gynecology Physician
  • Roswell, NM
National Provider Identifier
1821049727
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD2012-0806 Issued in NM
Practice address
305 W Country Club Rd
Roswell, NM 88201-5892
Phone
(575) 622-6322
Fax
(575) 622-6888
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD2012-0806 NM Primary
Obstetrics & Gynecology Physician 207V00000X 37784 AZ
Obstetrics & Gynecology Physician 207V00000X 36091802 IL

Addresses

Primary practice location

305 W Country Club Rd
Roswell, NM 88201-5892

Mailing address

PO Box 2608
Roswell, NM 88202-2608
Phone (575) 622-6322

Other identifiers 3

IdentifierTypeStateIssuer
036091802MedicaidIL
PENDINGMedicaidAZ
305790MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20130226000238 NM Practitioner - Obstetrics/Gynecology 9234129834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rush Medical College of Rush University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rio Pecos Medical Associates LTDGroup PAC ID 5597746875, 10 clinicians

Practice addresses (Care Compare)

305 W Country Club Rd
Roswell, NM 88201-5892
Phone (575) 622-6322

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37784AZMDObstetrics & Gynecology Physician
36091802ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rio Pecos Medical Associates LTD Obstetrics & Gynecology CurrentSince Nov 1, 2012 Accepting new patients
Payson Healthcare Management Inc Obstetrics & Gynecology PastSince Oct 1, 1999 Accepting new patients
Roswell Hospital Corporation Past Accepting new patients
Lovelace Health System LLC Past Accepting new patients

Locations

305 W Country Club Rd
Ste 3
Roswell, NM 88201

305 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-6322

Interoperability endpoints

  • Direct secure messaging: jdacanay477110@christushealth.direct-ci.net

Organizations & group practices 4

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 1

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1821049727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2608",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882022608",
            "telephone_number": "575-622-6322",
            "fax_number": "575-622-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015892",
            "telephone_number": "575-622-6322",
            "fax_number": "575-622-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACANAY",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2012-0806",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "37784",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "36091802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091802",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305790",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.