Gwenneth O Cancino, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0046268 Issued in MD

Practice address

115 W Bel Air Avenue
Aberdeen, MD 21001-3221

Phone

(410) 272-3377

Fax

(410) 273-1479

NPI assigned

May 24, 2005

Last updated

Nov 8, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

State University of Ny Upstate Medical University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Prohealth Primary Care LLCGroup PAC ID 7214183227, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gcancino@578.securemail.prognocis.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prohealth Primary Care LLC

  • Pediatrics Physician
  • Aberdeen, MD
  • NPI 1982962692

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Landmark Medical Group LLC

  • Internal Medicine Physician
  • Bel Air, MD
  • NPI 1538134747

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1487657227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W BEL AIR AVENUE",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210013221",
            "telephone_number": "410-272-1692",
            "fax_number": "410-272-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W BEL AIR AVENUE",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210013221",
            "telephone_number": "410-272-3377",
            "fax_number": "410-273-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCINO",
        "first_name": "GWENNETH",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0046268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "H9660002",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MD",
            "identifier": "53276204",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323951900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole J Brown, PT, DPT
• Tyler Buege, PT
• Wayne E Burkholtz, DPT
• John Merren Byrne, D.O.
• Christopher James Cancino, M.D.
• Capital Care Anesthesia LLC
• Capitol Staffing Services LLC
• Capricorn Health LLC (Capricorn Health)
• Careplus, LLC
• Carr Professional Association (Carr Family Dentistry, Aberdeen)

• Family Medicine Physician in Aberdeen, MD
• Providers in Aberdeen, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.