Individual provider Active NPI

Vincent James Cancilla

  • Anesthesiologist Assistant
  • Mansfield, OH
National Provider Identifier
1639045404
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
335 Glessner Ave
Mansfield, OH 44903-2269
Phone
(419) 520-2882
NPI assigned
Oct 16, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X Primary

Addresses

Primary practice location

335 Glessner Ave
Mansfield, OH 44903-2269

Mailing address

9205 Shenandoah Dr
North Royalton, OH 44133-1563
Phone (440) 341-3546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260223001513 OH Practitioner - Anesthesiology Assistant 2668953217 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Mansfield, IncGroup PAC ID 3870486624, 26 clinicians

Practice addresses (Care Compare)

335 Glessner Ave
Mansfield, OH 44903-2269
Phone (419) 526-8000

Hospital & facility affiliations

  • Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Mansfield, Inc CurrentSince Feb 2, 2026 Accepting new patients

Locations

335 Glessner Ave
Mansfield, OH 44903
Phone (419) 522-0320

Organizations & group practices 1

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1639045404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 SHENANDOAH DR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331563",
            "telephone_number": "440-341-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 GLESSNER AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032269",
            "telephone_number": "419-520-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCILLA",
        "first_name": "VINCENT",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.