NPIMap

Individual provider Active NPI

Gina Lynn Canada, D.O.

  • Family Medicine Physician
  • Connellsville, PA
National Provider Identifier
1841414836
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS013321 Issued in PA
Practice address
2618 Memorial Blvd Ste B-1
Connellsville, PA 15425-1419
Phone
(724) 628-3944
Fax
(724) 628-3798
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS013321 PA Primary

Addresses

Primary practice location

2618 Memorial Blvd Ste B-1
Connellsville, PA 15425-1419

Mailing address

2618 Memorial Blvd Ste B-1
Connellsville, PA 15425-1419
Phone (724) 628-3944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071022000254 PA Practitioner - Family Practice 1355437369 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fayette Physician Network IncGroup PAC ID 3375865819, 309 clinicians

Practice addresses (Care Compare)

500 W Berkeley St
Uniontown, PA 15401-5514
Phone (724) 430-6899

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS013321PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fayette Physician Network Inc Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Highlands Hospital and Health Center Family Medicine CurrentSince Sep 12, 2007 Accepting new patients
Fayette Physician Network Inc Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Fayette Physician Network Inc Family Medicine Past Accepting new patients

Locations

814 Vanderbilt Rd
Connellsville, PA 15425
Phone (724) 628-0450

401 E Murphy Ave
Connellsville, PA 15425
Phone (724) 626-2343

2618 Memorial Blvd
Ste B1
Connellsville, PA 15425
Phone (724) 628-3944

109 Crossroads Rd
Ste 201
Scottdale, PA 15683
Phone (724) 628-7432

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

Interoperability endpoints

  • Direct secure messaging: gcanada303306@direct.wvuhsdirect.com

Organizations & group practices 5

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1841414836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2618 MEMORIAL BLVD STE B-1",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251419",
            "telephone_number": "724-628-3944",
            "fax_number": "724-628-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2618 MEMORIAL BLVD STE B-1",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154251419",
            "telephone_number": "724-628-3944",
            "fax_number": "724-628-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "GINA",
        "middle_name": "LYNN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS013321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

Verify at the official NPI Registry.