ETNY RAUL CANDELARIO (MD) – Family Medicine Physician, NPI 1568084150
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
1,488 FAMILY PRACTICE in MD
Provider Addresses for ETNY RAUL CANDELARIO (MD)
1816 WEYBRIDGE RD
FREDERICK, MD 217025926
Phone: (240) 413-4767
Type: Mailing
1339 Fair Ave
San Antonio, TX 782231437
Phone: (210) 923-4372
Fax: (210) 923-5581
Type: Location
1339 FAIR AVE
SAN ANTONIO, TX 782231437
Phone: (210) 923-4372
Fax: (210) 923-5581
Type: Mailing
100 PERKINS FARM DR STE 203
MYSTIC, CT 063554041
Phone: (860) 576-8911
Fax: (860) 572-7758
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $342.
Total Amount is formed as General ($342) + Research ($0) + Ownership ($0) = $342.
Last reported payment date: 2024-08-28 • Largest payer in this snapshot: Lilly USA, LLC ($156).
Total Amount
$342
General + Research + Ownership
Payments
14
Total payment records
General Amount
$342
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-28
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2024-09-04
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240904001976 | I | Family Practice | CT | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 19 | 15 | $0 |
Insurance plans in this area (ZIP 21702)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | CT | |
| - | CT | |
| - | MA | |
| - | CT | |
| Internal Medicine | IL | |
| - | CT | |
| - | CT | |
| Nurse Practitioner | CT | |
| - | CT | |
| Internal Medicine | CT |
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