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DOMENIC JOSEPH CANCILLA PMHNP-BC
NPI 1487318713
Nurse Practitioner - Psychiatric/Mental Health in Toledo, OH

Active since October 22, 2021PECOS EnrolledAccepts Medicare Assignment
2005 ASHLAND AVE, TOLEDO, OH 43620(419) 841-7701(419) 841-1691 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2024, Oct 22, 2021 (2 updates tracked since 2021).

About Domenic Joseph Cancilla Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMENIC JOSEPH CANCILLA PMHNP-BC (NPI 1487318713) is an individual psychiatric/mental health provider in Toledo, Ohio, licensed in Ohio (APRN.CNP.0030043) and active in the NPI registry since October 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Oregon, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1487318713
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameDOMENIC JOSEPH CANCILLACredential: PMHNP-BC
Location Address2005 ASHLAND AVEToledo, OH 43620-1703
Mailing Address2005 Ashland AveToledo, OH 43620-1703 · (419) 841-7701 · Fax (419) 841-1691
Phone(419) 841-7701
Fax(419) 841-1691
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 22, 2021
Last NPPES UpdateJune 27, 20242 updates tracked since enumeration
NPPES CertifiedJune 27, 2024
✔ NPI 1487318713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in OH · APRN.CNP.0030043
2005 ASHLAND AVE, Toledo, OH 43620
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Secondary Practice Location 1

Location 12600 Navarre AveOregon, OH 43616-3207 · Phone (419) 696-8800

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Domenic Joseph Cancilla Pmhnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658760368
PECOS Enrollment IDI20211118002725
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
16 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43620 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANALI ROY M.SC., MA
Psychologist
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
KIANA COLE
Case Manager/Care Coordinator
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
DANCIE MARIE MURREY
Licensed Practical Nurse
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
LORENA PECINA
Case Manager/Care Coordinator
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
MIRANDA BATIANIS
Social Worker
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
SHANELLE CUNNINGHAM
Licensed Practical Nurse
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
DION MIKOLAJCZYK
Counselor (Addiction (Substance Use Disorder))
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701
BRYAN HAGER
Case Manager/Care Coordinator
2005 ASHLAND AVE
TOLEDO, OH 43620
Lucas County (419) 841-7701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Domenic Cancilla's NPI number?

The NPI number for Domenic Cancilla is 1487318713. It was assigned to this individual provider in the NPPES registry on October 22, 2021.

Where is Domenic Cancilla located?

Domenic Cancilla practices at 2005 Ashland Ave, Toledo, OH 43620. The listed phone number is (419) 841-7701.

What is Domenic Cancilla's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Domenic Cancilla enrolled in Medicare?

Yes. Domenic Cancilla is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Domenic Cancilla accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, McLaren Health Plan Community, MedMutual and Oscar Health Insurance and 3 other insurers list Domenic Cancilla as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Domenic Cancilla was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.