Individual provider Active NPI

Paulo J Cancado, M.D.

  • Neurology Physician
  • Kennewick, WA
National Provider Identifier
1902891104
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD0000033734 Issued in WA
Practice address
216 W 10TH Ave
Suite 304
Kennewick, WA 99336-6300
Phone
(509) 585-5972
Fax
(509) 586-5701
NPI assigned
Sep 13, 2005
Last updated
Jun 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD0000033734 WA Primary

Addresses

Primary practice location

216 W 10TH Ave
Suite 304
Kennewick, WA 99336-6300

Mailing address

216 W 10TH Ave
Suite 304
Kennewick, WA 99336-6304
Phone (509) 585-5972

Other identifiers 3

IdentifierTypeStateIssuer
0160721OtherWALABOR & INDUSTRIES #
1116714MedicaidWA
8936953OtherWACRIME VICTIMS NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20120622000126 WA Practitioner - Neurology 3476444910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7211 W Deschutes Ave
Suite D201
Kennewick, WA 99336-7715
Phone (509) 586-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.57 of 100Reported as individual
Quality
97.14
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000033734WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-City Neurology, Inc. Neurology CurrentSince Aug 1, 2002 Accepting new patients

Locations

216 W 10th Ave
Ste 304
Kennewick, WA 99336
Phone (509) 586-5677

7211 W Deschutes Ave
Ste D201
Kennewick, WA 99336
Phone (509) 586-5700

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1902891104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 W 10TH AVE",
            "address_2": "SUITE 304",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366304",
            "telephone_number": "509-585-5972",
            "fax_number": "509-586-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 W 10TH AVE",
            "address_2": "SUITE 304",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366300",
            "telephone_number": "509-585-5972",
            "fax_number": "509-586-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCADO",
        "first_name": "PAULO",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-13",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD0000033734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES #",
            "identifier": "0160721",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116714",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS NUMBER",
            "identifier": "8936953",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.