Individual provider Active NPI

Cristina Roble Castaneda, MD

  • Pediatrics Physician
  • Pago Pago, AS
National Provider Identifier
1073397543
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5066-C Issued in AS
Practice address
96799 Turner Drive
Pago Pago, AS 96799
Phone
(684) 633-1222
Fax
(684) 633-5107
NPI assigned
Aug 24, 2023
Last updated
Aug 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5066-C AS Primary

Addresses

Primary practice location

96799 Turner Drive
Pago Pago, AS 96799

Mailing address

PO Box LBJ
Pago Pago, AS 96799-0010
Phone (684) 633-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AS
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
I20240610002182 AS Practitioner - Pediatric Medicine 1759823446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5066-CASMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Samoa Medical Center CurrentSince Apr 10, 2024 Accepting new patients

Organizations & group practices 1

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": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1073397543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX LBJ",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "967990010",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96799 TURNER DRIVE",
            "city": "PAGO PAGO",
            "state": "AS",
            "postal_code": "96799",
            "telephone_number": "684-633-1222",
            "fax_number": "684-633-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "CRISTINA",
        "middle_name": "ROBLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AS",
            "license": "5066-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pago Pago, AS

Sources for this page

Verify at the official NPI Registry.