Jennifer Cancino, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0058038 Issued in MD

Practice address

7211 Bank CT
Frederick, MD 21703-8483

Phone

(240) 215-6370

NPI assigned

Aug 18, 2005

Last updated

Apr 30, 2019By 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 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.cancino.1@30520.direct.athenahealth.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.

• Frederick Health Medical Group LLC

  dba Frederick Health Medical Group

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1619258225
  Medicare reassignment NPD
• Frederick Health Medical Group LLC

  • Family Medicine Physician
  • Mount Airy, MD
  • NPI 1114771862
  NPD
• Frederick Health Medical Group LLC

  dba Frederick Health Medical Group

  • Orthopaedic Surgery Physician
  • Frederick, MD
  • NPI 1790053361
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1780676353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1110",
            "city": "UNION BRIDGE",
            "state": "MD",
            "postal_code": "217910579",
            "telephone_number": "410-775-2622",
            "fax_number": "410-775-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 BANK CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038483",
            "telephone_number": "240-215-6370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 N Main St",
            "address_purpose": "LOCATION",
            "city": "Union Bridge",
            "state": "MD",
            "postal_code": "217919102",
            "country_code": "US",
            "telephone_number": "410-775-2622",
            "fax_number": "410-775-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANCINO",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0058038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PVN",
            "identifier": "2600321",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "1989337",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS MARYLAND",
            "identifier": "613037-01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS GHMSI",
            "identifier": "W590-0003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Campbell, LCSW-C
• Quentin Ross Campbell, DPT
• Juliana E Camponeschi, M.S. CCC-SLP
• Gregorina Altagracia Campusano
• Brandon Dieter Canaza, RDH
• Alexis Claire Candeloro
• Kenneth Cann
• Linda A Cann, MSN,APRN,FNP,PMHNP
• Portia ABA Cann
• Tracey Michelle Cannon

• Family Medicine Physician in Frederick, MD
• Providers in Frederick, 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 Apr 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.