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JACOB DANIEL CANAVAN MD
NPI 1104402908
Emergency Medicine in Bronx, NY

Active since March 22, 2021PECOS Enrolled
1650 GRAND CONCOURSE, BRONX, NY 10457(718) 992-7669 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 3, 2024, Mar 22, 2021 (2 updates tracked since 2021).

About Jacob Daniel Canavan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB DANIEL CANAVAN MD (NPI 1104402908) is an individual emergency medicine provider in Bronx, New York, licensed in New York (327964) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in New York.

NPPES Registry Identity

NPI1104402908
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJACOB DANIEL CANAVANCredential: MD
Location Address1650 GRAND CONCOURSEBronx, NY 10457-7679
Mailing Address1650 Grand ConcourseBronx, NY 10457-7679 · (718) 992-7669
Phone(718) 992-7669
Sole ProprietorNo
Enumeration DateMarch 22, 2021
Last NPPES UpdateSeptember 3, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
✔ NPI 1104402908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NY · 327964
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1650 GRAND CONCOURSE, Bronx, NY 10457
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Secondary Practice Location 1

Location 1250 W 57th StNew York, NY 10107-0001 · Phone (212) 523-8158

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Daniel Canavan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSIE LAUREN GREEN M.S., CCC-SLP
Speech-Language Pathologist
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (201) 281-3781
ARAMARK
Clinic/Center
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (646) 641-7427
MAY YEE HELMAN M.D.
Emergency Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
ANDREA ELIZABETH SPIEKHOUT D.O.
Family Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
VINCENT SETIAWAN PRAWOKO MD
Student in an Organized Health Care Education/Training Program
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (347) 601-1241
HAIDER GHAZANFAR
Internal Medicine (Gastroenterology)
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (917) 856-6383
MATTHEW PEACHEY MD
Internal Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 992-7669
TRACY RAU MD
Family Medicine
1650 GRAND CONCOURSE
BRONX, NY 10457
Bronx County (718) 590-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Canavan's NPI number?

The NPI number for Jacob Canavan is 1104402908. It was assigned to this individual provider in the NPPES registry on March 22, 2021.

Where is Jacob Canavan located?

Jacob Canavan practices at 1650 Grand Concourse, Bronx, NY 10457. The listed phone number is (718) 992-7669.

What is Jacob Canavan's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jacob Canavan enrolled in Medicare?

Yes. Jacob Canavan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacob Canavan was last updated on September 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.