Jorge L Candiotti, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17258 Issued in TX

Practice address

1604 Lancaster Dr
Grapevine, TX 76051-3544

Phone

(855) 893-5637

NPI assigned

Dec 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jorge Luis Candiotti Herrera Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primamed Physicians, PLLCGroup PAC ID 9234027897, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.candiottipac.p11@direct.nextcare.nextgenshare.com
• Direct secure messaging: jorge.candiotti.1@27041.direct.athenahealth.com
• Direct secure messaging: jcandiotti277246@direct.ahn.org

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.

• Primamed Physicians PLLC

  • Urgent Care Clinic/Center
  • Dallas, TX
  • NPI 1164494068

  TX

  Medicare reassignment Care Compare group NPD
• Citimed, P.a.

  • Family Medicine Physician
  • Arlington, TX
  • NPI 1487823316
  NPD (past)

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1245877679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 LEIGHTON CT",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160467108",
            "telephone_number": "412-841-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 LANCASTER DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513544",
            "telephone_number": "855-893-5637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12311 Perry Hwy",
            "address_purpose": "LOCATION",
            "city": "Wexford",
            "state": "PA",
            "postal_code": "150908344",
            "country_code": "US",
            "telephone_number": "878-332-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDIOTTI",
        "first_name": "JORGE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-04",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA061288",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcandiotti277246@direct.ahn.org",
            "affiliation": "N",
            "address_1": "12311 Perry Hwy",
            "city": "Wexford",
            "state": "PA",
            "country_code": "US",
            "postal_code": "150908344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JORGE",
            "last_name": "CANDIOTTI HERRERA",
            "middle_name": "LUIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Angela Byrd, LPC
• Madison Wren Byrne
• Douglas Alexander Calenda II, PA-C
• Cherye C Callegan, M.D.
• Tamlynn Cameron, L.M.T.
• Roderick Marcus Capelo, M.D.
• Capili MD PA
• Carleo A Capili, MD
• Regina R Capili, MD
• Jeffrey Atkins Caraway, PT, DPT

• All providers in Grapevine, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.
• 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.