Individual provider Active NPI

Candice Evita Ortiz-Hawkins, AUD

  • Audiologist
  • Silver Spring, MD
National Provider Identifier
1861629594
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01505 Issued in MD
Practice address
11886 Healing Way Ste 530
Silver Spring, MD 20904-7917
Phone
(240) 670-1200
Fax
(240) 719-0534
NPI assigned
Jun 21, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01505 MD Primary
Audiologist 231H00000X AT006280 PA

Addresses

Primary practice location

11886 Healing Way Ste 530
Silver Spring, MD 20904-7917

Mailing address

11886 Healing Way Ste 530
Silver Spring, MD 20904-7917
Phone (240) 670-1200

Other identifiers 1

IdentifierTypeStateIssuer
1715321005MedicaidMD

Other names 1

  • Candice Ortiz Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211019000804 DC Practitioner - Qualified Audiologist 6204989882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Institute of Hearing and Balance LLCGroup PAC ID 7214332139, 5 clinicians

Practice addresses (Care Compare)

11886 Healing Way
Suite 530
Silver Spring, MD 20904-7917
Phone (240) 670-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01505MDMDAudiologist
AT006280PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Institute of Hearing & Balance LLC Audiologist CurrentSince Dec 10, 2021 Accepting new patients
Capital Institute of Hearing & Balance LLC CurrentSince Dec 10, 2021 Accepting new patients

Locations

8401 Connecticut Ave
Ste 100
Chevy Chase, MD 20815
Phone (240) 670-1200

11886 Healing Way
Ste 530
Silver Spring, MD 20904
Phone (240) 670-1200

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.

NPI Registry JSON

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

{
    "created_epoch": "1245542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1861629594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11886 HEALING WAY STE 530",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047917",
            "telephone_number": "240-670-1200",
            "fax_number": "240-719-0534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11886 HEALING WAY STE 530",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047917",
            "telephone_number": "240-670-1200",
            "fax_number": "240-719-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ-HAWKINS",
        "first_name": "CANDICE",
        "middle_name": "EVITA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-21",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01505",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006280",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715321005",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDICE",
            "last_name": "ORTIZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.