Organization Active NPI

Caduceus Skilled Health Care Services LLC

  • General Practice Physician
  • Paramus, NJ
National Provider Identifier
1871460345
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CADUCEUS SKILLED HEALTH CARE SERVICES LLC
Practice address
501 N Rte 17 Ste 1
Paramus, NJ 07652-3000
Phone
(201) 456-5367
NPI assigned
Oct 20, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Lisa Cannon, MDNPI 1073562773
Title
Owner
Phone
(201) 456-5367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

501 N Rte 17 Ste 1
Paramus, NJ 07652-3000

Mailing address

2105 Freeman Way
Allendale, NJ 07401-1780
Phone (201) 456-5367

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251223004239 NJ Part B Supplier - Clinic/Group Practice 3072008333 Receives reassigned benefits from 1 practitioner
Practice locations: Allendale, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1871460345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 FREEMAN WAY",
            "city": "ALLENDALE",
            "state": "NJ",
            "postal_code": "074011780",
            "telephone_number": "201-456-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N RTE 17 STE 1",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523000",
            "telephone_number": "201-456-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADUCEUS SKILLED HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-456-5367",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.