Etny Raul Candelario, MD - Medicare Family Medicine in Mystic, CT

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Etny Raul Candelario, MD is a medicare enrolled "Family Medicine" physician in Mystic, Connecticut. His current practice location is 100 Perkins Farm Dr Ste 203, Mystic, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 576-8911.

Etny Raul Candelario is licensed to practice in Connecticut (license number 79070) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1568084150.

Contact Information

Etny Raul Candelario, MD
100 Perkins Farm Dr Ste 203,
Mystic, CT 06355-4041
(860) 576-8911
(860) 572-7758

Map and Direction




Physician's Profile

Full NameEtny Raul Candelario
GenderMale
SpecialityFamily Medicine
Location100 Perkins Farm Dr Ste 203, Mystic, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1568084150
  • Provider Enumeration Date: 05/18/2020
  • Last Update Date: 08/23/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4981086162
  • Enrollment ID: I20231006001052

Medical Identifiers

Medical identifiers for Etny Raul Candelario such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1568084150NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 4301510053 (Michigan)Secondary
207Q00000XFamily Medicine U6458 (Texas)Secondary
207Q00000XFamily Medicine 79070 (Connecticut)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Etny Raul Candelario allows following entities to bill medicare on his behalf.
Entity NameConviva Medical Center Management Of Texas, P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1770988990
PECOS PAC ID: 8729302278
Enrollment ID: O20150112000488

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Etny Raul Candelario is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Etny Raul Candelario, MD
1339 Fair Ave,
San Antonio, TX 78223-1437

Ph: (210) 923-4372		Etny Raul Candelario, MD
100 Perkins Farm Dr Ste 203,
Mystic, CT 06355-4041

Ph: (860) 576-8911

Reviews and Comments


Family Medicine Doctors in Mystic, CT

Dr. Harold Eugene Phillips Jr., M.D.
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Phone: 860-536-6442    Fax: 860-536-6442
Dr. Sungsil Cho, MD
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Phone: 860-572-5782    
Brandi Lynn Iovino, D.O.
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Practice Location: 41 E Main St, Mystic, CT 06355
Phone: 860-572-2988    
Dr. Michael J Feltes, M.D.
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Practice Location: 3 Heron Rd, Mystic, CT 06355
Phone: 860-536-6442    Fax: 860-536-6442

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.