Santiago Angel Candocia, M.D.
Individual provider Active NPI Internal Medicine Physician · Winnetka, IL
NPI 1780764019 · NPPES record last updated Feb 15, 2017
Key facts
- NPI
- 1780764019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036077782 (IL)
- Practice address
- 710 Oak St
Winnetka, IL 60093-2522 - Phone
- (847) 986-6770
- Fax
- (224) 505-5960
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Dedication Health LLC
Practice addresses (Care Compare)
710 Oak St
Winnetka, IL 60093-2522
Phone (847) 986-6770
Hospital & facility affiliations
- Access Life Care, LTD
- Northshore University Healthsystem - Evanston Hospital
- Swedish Hospital
- Northwestern Lake Forest Hospital
- VI at the Glen
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.97 of 100
- Quality
- 68.96
- Improvement activities
- 40
- Cost
- 57.97
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071020000063 | IL | Practitioner - Internal Medicine | 3779679840 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036077782 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dedication Health LLC | Internal Medicine | Current |
Accepting new patients |
| North Groves Internal Medicine SC | Internal Medicine | Past | Accepting new patients |
Locations
710 Oak St
Winnetka, IL 60093
Phone (847) 840-1470
Interoperability endpoints
- santiago.candocia.1@13127.direct.athenahealth.com
- https://api.platform.athenahealth.com/13127/brand/1/csg/1/fhir/r4
- https://api.platform.athenahealth.com/6691/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036077782 | IL | Yes |
Addresses
Primary practice location
710 Oak St
Winnetka, IL 60093-2522
Mailing address
710 Oak St
Winnetka, IL 60093-2522
Phone (847) 986-6770
Other providers in Winnetka, IL
- Bone and Body Women'S Health, LLC
- Randy C Bugayong
- Christopher Bulf
- Robert William Burton
- Meghan Cabrera
- Norma Canelas
- Care Endocrinology, PLLC
- Carole P Prete MD PLLC
- Stephanie V Cavanaugh
- Katherine M Ceisel
All providers in Winnetka, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.