Individual provider Active NPI

Angela Candelaria, M.D.

  • Hospitalist Physician
  • Fairfield, CT
National Provider Identifier
1689961864
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
ME127307 Issued in FL
Practice address
52 Beach Rd Ste 105
Fairfield, CT 06824-6017
Phone
(203) 334-5959
Fax
(203) 298-9035
NPI assigned
Jul 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054643 CT
Hospitalist Physician 208M00000X ME127307 FL Primary

Addresses

Primary practice location

52 Beach Rd Ste 105
Fairfield, CT 06824-6017

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-9358

Other practice location 1

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-9358

Other identifiers 2

IdentifierTypeStateIssuer
017738700MedicaidFL
IP262ZOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160203001710 CT Practitioner - Internal Medicine 3577867076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians
Advanced Cardiovascular Specialists PCGroup PAC ID 4880678846, 13 clinicians

Practice addresses (Care Compare)

1931 Black Rock Tpke
Fairfield, CT 06825-3506
Phone (203) 384-8681

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3000

439 Mill Hill Ave
Bridgeport, CT 06610-2866
Phone (203) 334-2100

555 Bridgeport Ave
Shelton, CT 06484-4749
Phone (203) 922-1773

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
054643CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Internal Medicine CurrentSince Dec 4, 2015 Accepting new patients
Advanced Cardiovascular Specialists PC CurrentSince Feb 1, 2019 Accepting new patients

Locations

439 Mill Hill Ave
Bridgeport, CT 06610
Phone (203) 334-2100

267 Grant St
Bridgeport, CT 06610
Phone (203) 384-3170

24 Hospital Ave
Danbury, CT 06810
Phone (203) 739-7118

52 Beach Rd
Ste 105
Fairfield, CT 06824
Phone (203) 334-5959

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: acandelaria117487@direct.ynhh.org

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 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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1689961864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-9358",
            "fax_number": "321-951-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BEACH RD STE 105",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246017",
            "telephone_number": "203-334-5959",
            "fax_number": "203-298-9035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8745 N Wickham Rd",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329405997",
            "country_code": "US",
            "telephone_number": "321-434-9358",
            "fax_number": "321-434-9521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANDELARIA",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-07",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054643",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME127307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017738700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IP262Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.