NPIMap

Individual provider Active NPI

Candice E Ortiz, MD

  • Diagnostic Radiology Physician
  • St Johnsbury, VT
National Provider Identifier
1093814139
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
042-0009723 Issued in VT
Practice address
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone
(802) 748-7567
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound Physician 2085U0001X 042-0009723 VT
Diagnostic Radiology Physician 2085R0202X 042-0009723 VT Primary

Addresses

Primary practice location

1315 Hospital Dr
St Johnsbury, VT 05819-9210

Mailing address

PO Box 1849
Lewiston, ME 04241-1849
Phone (877) 845-2926

Other identifiers 1

IdentifierTypeStateIssuer
0VN1813MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081201000175 VT Practitioner - Diagnostic Radiology 6709946379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vermont RadiologistsGroup PAC ID 9830287697, 3 clinicians

Practice addresses (Care Compare)

1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone (802) 748-3638

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.07 of 100Reported as group
Quality
59.54
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0009723VTMDDiagnostic Ultrasound Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vermont Radiologists Diagnostic Radiology CurrentSince Dec 9, 1997 Accepting new patients
Vermont Open MRI Past Accepting new patients

Locations

528 Washington Hwy
Morrisville, VT 05661
Phone (802) 888-4231

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 2

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.

Hospital & facility affiliations 10

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093814139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1849",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042411849",
            "telephone_number": "877-845-2926",
            "fax_number": "207-777-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "CANDICE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "VT",
            "license": "042-0009723",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VT",
            "license": "042-0009723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1813",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.