MARY CANONICO (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1811465594

MARY CANONICO (PMHNP-BC) is a healthcare provider. based in Berea, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials PMHNP-BC. They hold a License No. 023823 (OH). The NPI Number for MARY CANONICO (PMHNP-BC) is 1811465594

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MARY CANONICO (PMHNP-BC)
NPI
1811465594
Phone
(440) 234-2006
Address
202 E BAGLEY RD
Enumeration Date
11 November 2018
Last Update Date
30 January 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3303446047
Graduation Year
2018 (8 years ago)
PAC ID
7517292980
Group Practice PAC ID
8426961061
Professional Enrollment ID
I20190709000433
Address ID
OH443072432AK1XXXXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

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Provider Addresses for MARY CANONICO (PMHNP-BC)

  • 202, East Bagley Road, Berea, Cuyahoga County, Ohio, 44017, United States

    BEREA, OH 440172058

    Phone: (440) 234-2006

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $1,929.

Total Amount is formed as General ($1,929) + Research ($0) + Ownership ($0) = $1,929.

Last reported payment date: 2024-05-17 • Largest payer in this snapshot: Neuronetics, Inc. ($1,929).

Total Amount

$1,929

General + Research + Ownership

Payments

2

Total payment records

General Amount

$1,929

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-17

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Neuronetics, Inc.$1,929
View all Open Payments →|Open Payments Risk Radar →

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: 2019-07-09

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
I20190709000433INurse PractitionerOHTBD

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 44017)

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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: 8426961061View full group profile
NameSpecialtyState
Nurse PractitionerOH
Physician AssistantOH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH
Physician AssistantOH
-OH
Nurse PractitionerOH
Nurse PractitionerOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

What number should I use to identify MARY CANONICO (PMHNP-BC) for billing?
Administrative and clinical systems typically use NPI 1811465594 for MARY CANONICO (PMHNP-BC).
Is MARY CANONICO (PMHNP-BC) currently accepting referrals based on NPI status?
Registry metadata lists MARY CANONICO (PMHNP-BC) as active.
What services align with MARY CANONICO (PMHNP-BC)'s listing?
MARY CANONICO (PMHNP-BC)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What geographic area is tied to MARY CANONICO (PMHNP-BC)?
MARY CANONICO (PMHNP-BC) is associated with Berea, Ohio in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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