Individual provider Active NPI

Juan Carlos Castaneda, DO

  • Surgery of the Hand (Surgery) Physician
  • South Daytona, FL
National Provider Identifier
1043248362
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
License
OS9696 Issued in FL
Practice address
667 Beville Rd Ste B
South Daytona, FL 32119-1955
Phone
(386) 322-6882
Fax
(386) 322-6848
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery of the Hand (Surgery) Physician 2086S0105X OS9696 FL Primary

Addresses

Primary practice location

667 Beville Rd Ste B
South Daytona, FL 32119-1955

Mailing address

667 Beville Rd Ste B
South Daytona, FL 32119-1955
Phone (386) 322-6882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060103000205 FL Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 4688696875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
New York College of Osteo Medicine of New York Institute of Technology, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

385 Palm Coast Pkwy SW
Unit 1
Palm Coast, FL 32137-4784
Phone (386) 597-2776

667 Beville Rd
Suite B
South Daytona, FL 32119-1955
Phone (386) 322-6882

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS9696FLMDSurgery of the Hand (Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hand & Upper Extremity Surgery of Daytona Beach, LLC Surgery of the Hand CurrentSince Dec 1, 2007 Accepting new patients
Hand & Upper Extremity Surgery of Daytona Beach, LLC Current Accepting new patients

Locations

385 Palm Coast Pkwy SW
Unit 1
Palm Coast, FL 32137
Phone (386) 322-6882

667 Beville Rd
Ste B
South Daytona, FL 32119
Phone (386) 322-2224

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1043248362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 BEVILLE RD STE B",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191955",
            "telephone_number": "386-322-6882",
            "fax_number": "386-322-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 BEVILLE RD STE B",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191955",
            "telephone_number": "386-322-6882",
            "fax_number": "386-322-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "FL",
            "license": "OS9696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.