Active NPI
Michael J Canino, M.D.
- Psychiatry Physician
- Philadelphia, PA
National Provider Identifier
1992966196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD440897
- Practice address
- 230 S Broad St
Suite 600
Philadelphia, PA 19102-4121 - Phone
- (215) 893-0141
- NPI assigned
- Jun 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD440897 | PA | Primary |
Addresses
Primary practice location
230 S Broad St
Suite 600
Philadelphia, PA 19102-4121
Mailing address
230 S Broad St
Suite 600
Philadelphia, PA 19102-4121
Phone (215) 893-0141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 26, 2019 through Mar 26, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD440897 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378166400000",
"number": "1992966196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 S BROAD ST",
"address_2": "SUITE 600",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191024121",
"telephone_number": "215-893-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 S BROAD ST",
"address_2": "SUITE 600",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191024121",
"telephone_number": "215-893-0141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANINO",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-19",
"last_updated": "2013-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD440897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.