KEVIN CANNAVINA – Obstetrics & Gynecology Physician, NPI 1356924849

KEVIN CANNAVINA is a healthcare provider. based in Berkeley heights, New Jersey. specializing in OBSTETRICS/GYNECOLOGY. They hold a License No. 25MB12788000 (NJ). The NPI Number for KEVIN CANNAVINA is 1356924849

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
KEVIN CANNAVINA
NPI
1356924849
Phone
Not provided
Address
1 DIAMOND HILL RD
Enumeration Date
3 May 2021
Last Update Date
9 September 2025

Doctor Profile

Medical School Name
LAKE ERIE COL OF OSTEO MED AT SETON HILL UNIV
Secondary Phone
9082734300
Graduation Year
2021 (5 years ago)
PAC ID
4183128192
Group Practice PAC ID
5395642276
Professional Enrollment ID
I20250922000487
Address ID
NJ079222104BE1XXXXRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Digital endpointsOther names

1,504 OBSTETRICS/GYNECOLOGY in NJ

Provider Addresses for KEVIN CANNAVINA

  • 1 DIAMOND HILL RD

    BERKELEY HEIGHTS, NJ 079222104

    Phone:

    Type: Mailing

  • 1896 MORRIS AVE

    UNION, NJ 070833535

    Phone: (908) 687-8282

    Type: Location

  • 148 Sun Valley Way

    Morris Plains, NJ 079502042

    Phone: (862) 812-5323

    Type: Location

  • 148 SUN VALLEY WAY

    MORRIS PLAINS, NJ 079502042

    Phone: (862) 812-5323

    Type: Mailing

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: 2025-09-22

PECOS data refreshed: 2026-06-15

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
I20250922000487IObstetrics/GynecologyNJTBD

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 07922)

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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: 5395642276View full group profile
NameSpecialtyState
U R O L O G YNJ
Radiation OncologyNY
-NJ
Physician AssistantPA
-NJ
Physical Therapist In Private PracticeNJ
-NJ
Hematology/Oncology, Medical OncologyOH
-NJ
G A S T R O E N T E R O L O G YNJ

Reviews

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Frequently asked questions

How do payers reference KEVIN CANNAVINA?
For KEVIN CANNAVINA, use NPI 1356924849 as the unique 10-digit identifier.
Active or inactive — what applies to KEVIN CANNAVINA?
You should see KEVIN CANNAVINA as active in CMS-hosted NPPES data.
What kind of doctor is KEVIN CANNAVINA?
KEVIN CANNAVINA is associated with Obstetrics & Gynecology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is KEVIN CANNAVINA located near Berkeley Heights?
KEVIN CANNAVINA currently maps to Berkeley Heights, New Jersey in this extract.
Can I trust this NPI listing for KEVIN CANNAVINA?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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