Individual provider Active NPI

Jennifer Castilloux, D.O

  • Internal Medicine Physician
  • Opa Locka, FL
National Provider Identifier
1063873883
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13817 Issued in FL
Practice address
401 Opa Locka Blvd
Opa Locka, FL 33054-3528
Phone
(786) 535-7200
Fax
(786) 535-7294
NPI assigned
Mar 8, 2016
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OS13817 FL Primary

Addresses

Primary practice location

401 Opa Locka Blvd
Opa Locka, FL 33054-3528

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (786) 535-7200

Other practice location 1

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2020

Other practice location 2

4300 Alton Rd
Miami Beach, FL 33140-2948
Phone (305) 674-2020

Other practice location 3

1000 Park Centre Blvd Ste 100
Miami, FL 33169
Phone (305) 621-0023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161112000165 FL Practitioner - Internal Medicine 7810276904 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chen Neighborhood Medical Centers of South Florida LLC CurrentSince Mar 6, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

401 Opa Locka Blvd
Opa Locka, FL 33054
Phone (786) 535-7200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1063873883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695710",
            "telephone_number": "786-535-7200",
            "fax_number": "786-535-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 OPA LOCKA BLVD",
            "city": "OPA LOCKA",
            "state": "FL",
            "postal_code": "330543528",
            "telephone_number": "786-535-7200",
            "fax_number": "786-535-7294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331402948",
            "country_code": "US",
            "telephone_number": "305-674-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4300 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331402948",
            "country_code": "US",
            "telephone_number": "305-674-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Park Centre Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "33169",
            "country_code": "US",
            "telephone_number": "305-621-0023",
            "fax_number": "305-731-2433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLOUX",
        "first_name": "JENNIFER",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-08",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opa Locka, FL

Sources for this page

Verify at the official NPI Registry.