Individual provider Active NPI

Philip Castaneda Jr., PA-C

  • Physician Assistant
  • Tacoma, WA
National Provider Identifier
1073885638
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60939283 Issued in WA
Practice address
Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-0001
Phone
(253) 968-3885
NPI assigned
Jan 29, 2012
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60939283 WA Primary

Addresses

Primary practice location

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-0001

Mailing address

Unit 30401
Apo, AE 09107

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211007003569 WA Practitioner - Physician Assistant 0840511515 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 2, 2021 Accepting new patients
Multicare Health System CurrentSince Jul 2, 2021 Accepting new patients

Locations

9550 195th Ave E
Bonney Lake, WA 98391
Phone (253) 447-3400

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

13106 Meridian E
Puyallup, WA 98373
Phone (253) 697-8860

14815 Pacific Ave S
Tacoma, WA 98444
Phone (253) 697-8660

Organizations & group practices 4

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": "1327795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1073885638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "UNIT 30401",
            "city": "APO",
            "state": "AE",
            "postal_code": "09107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "PHILIP",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-29",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60939283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.