Individual provider Active NPI

Reynaldo A Carandang, M.D.

  • Internal Medicine Physician
  • Vincennes, IN
National Provider Identifier
1316915895
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01039560A Issued in IN
Practice address
406 N 1St St
Vincennes, IN 47591-1340
Phone
(812) 885-0881
Fax
(812) 885-0886
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01039560A IN Primary

Addresses

Primary practice location

406 N 1St St
Vincennes, IN 47591-1340

Mailing address

406 N 1St St
Vincennes, IN 47591-1340
Phone (812) 885-0881

Other identifiers 1

IdentifierTypeStateIssuer
200008010AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20071022000197 IN Practitioner - Internal Medicine 8224124334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Good Samaritan Hospital Physician Services, IncGroup PAC ID 3971671330, 143 clinicians

Practice addresses (Care Compare)

406 N 1St St
Vincennes, IN 47591-1340
Phone (812) 882-1106

Hospital & facility affiliations

  • Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01039560AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Physician Services, Inc Internal Medicine CurrentSince Dec 1, 2008 Accepting new patients
Good Samaritan Hospital CurrentSince Dec 1, 2008 Accepting new patients
Good Samaritan Hospital Physician Services Inc. Past Accepting new patients

Locations

406 N 1st St
Vincennes, IN 47591
Phone (812) 882-1106

615 Dubois St
Vincennes, IN 47591
Phone (812) 885-8010

1160 E Saint Clair St
Vincennes, IN 47591
Phone (812) 882-1064

520 S 7th St
Vincennes, IN 47591
Phone (812) 885-3280

Interoperability endpoints

  • Direct secure messaging: rcarandang32686@direct.deaconess.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1316915895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911340",
            "telephone_number": "812-885-0881",
            "fax_number": "812-885-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N 1ST ST",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911340",
            "telephone_number": "812-885-0881",
            "fax_number": "812-885-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARANDANG",
        "first_name": "REYNALDO",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01039560A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200008010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincennes, IN

Sources for this page

Verify at the official NPI Registry.