ERIC CANONACO (DPT) – Physical Therapist, NPI 1003771528

ERIC CANONACO (DPT) is a healthcare provider. based in Fair lawn, New Jersey. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 40QA02392100 (NJ). The NPI Number for ERIC CANONACO (DPT) is 1003771528

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
ERIC CANONACO (DPT)
NPI
1003771528
Phone
(201) 291-0750
Address
17-17 ROUTE 208 STE 116
Enumeration Date
17 December 2025
Last Update Date
17 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2012910750
Graduation Year
2025 (1 year ago)
PAC ID
3678069614
Group Practice PAC ID
9436324886
Professional Enrollment ID
I20251230000829
Address ID
NJ074102819FA1717X208X401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

4,923 PHYSICAL THERAPIST IN PRIVATE PRACTICE in NJ

Provider Addresses for ERIC CANONACO (DPT)

  • 17-17 ROUTE 208 STE 116

    FAIR LAWN, NJ 074102819

    Phone: (201) 291-0750

    Fax: (201) 291-0753

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251230000829IPhysical Therapist In Private PracticeNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07410)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436324886View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeNJ
-NJ
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeNJ

Reviews

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Frequently asked questions

Can I use this page to confirm ERIC CANONACO (DPT)'s NPI?
Yes. ERIC CANONACO (DPT) is listed with NPI 1003771528 in the public NPI dataset.
Is ERIC CANONACO (DPT) listed as active for patients and plans?
The listing shows ERIC CANONACO (DPT) as active in the NPI system.
What is ERIC CANONACO (DPT)'s primary classification?
Physical Therapist is the headline specialty for ERIC CANONACO (DPT) here. Clinical services aligned with this taxonomy classification.
Does ERIC CANONACO (DPT) list a practice location?
Patients near Fair Lawn, New Jersey may find ERIC CANONACO (DPT) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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