Jenalyn Canullas

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00073600 Issued in NJ

Practice address

842 Broadway
West Long Branch, NJ 07764-1503

Phone

(732) 222-0180

Fax

(732) 222-3990

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: jenalyn.canullas.4@24114.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Diabetes Education and Wellness

  • Health Service Clinic/Center
  • Eatontown, NJ
  • NPI 1588053706
  Medicare reassignment Authorized official
• Medical Service Professionals of NJ LLC

  dba Clover Home Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Lyndhurst, NJ
  • NPI 1972044923
  Medicare reassignment

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881777100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 BROADWAY",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641503",
            "telephone_number": "732-222-0180",
            "fax_number": "732-222-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 BROADWAY",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641503",
            "telephone_number": "732-222-0180",
            "fax_number": "732-222-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANULLAS",
        "first_name": "JENALYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00073600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria A Bristol, RN, BSN, IBCLC
• Laura B. Brooks, MSN, FNP-C
• Thomas Brooks, EDD
• Cynthia Joyce Burden-Wells, M.A.C.C.C.
• Eric N Burkett, M.D.
• Robert L Carracino, M.D.
• Thomas Carroll
• Rena Chaiklin, PHARMD
• Elizabeth Chang
• Rosa Chaviano-Moran II, DMD

• Adult Health Nurse Practitioner in West Long Branch, NJ
• Providers in West Long Branch, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.