Individual provider Active NPI

Eduardo D Castillo, MD

  • Colon & Rectal Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1023035623
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
M1568 Issued in TX
Practice address
2000 Cooper St Ste 100B
Fort Worth, TX 76104-2528
Phone
(817) 924-9002
Fax
(817) 924-9960
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X M1568 TX Primary

Addresses

Primary practice location

2000 Cooper St Ste 100B
Fort Worth, TX 76104-2528

Mailing address

PO Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8400

Other identifiers 2

IdentifierTypeStateIssuer
173827001MedicaidTX
P00234425OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050701000284 TX Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 4385687664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
University of Texas Southwestern Medical School at Dallas, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

6100 Harris Pkwy
Suite 260
Fort Worth, TX 76132-4101
Phone (817) 339-8855

6700 Buenos Aires Dr
N Richland Hills, TX 76180-6566
Phone (817) 281-8245

Hospital & facility affiliations

  • Baylor Scott and White All Saints Medical Center Hospital, Fort Worth, TX, CCN 450137
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy42
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. CurrentSince Aug 1, 2005 Accepting new patients
Texas Health Care, P.L.L.C. Colon & Rectal Surgery CurrentSince Aug 1, 2005 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients

Locations

2000 Cooper St
Ste 100B
Fort Worth, TX 76104
Phone (817) 924-9002

1420 8th Ave
Ste 103
Fort Worth, TX 76104
Phone (817) 922-2273

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

Interoperability endpoints

  • Direct secure messaging: eduardo.castillo.p1@direct.thc.nextgenshare.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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1023035623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8400",
            "fax_number": "817-924-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 COOPER ST STE 100B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042528",
            "telephone_number": "817-924-9002",
            "fax_number": "817-924-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "EDUARDO",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "M1568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173827001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00234425",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.