Active NPI
Tirso A Castillo, MD
- Gastroenterology Physician
- Dublin, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 048883
- Practice address
- 111 Fairview Park Dr
Dublin, GA 31021-2501 - Phone
- (478) 272-1366
- Fax
- (478) 275-2322
- NPI assigned
- Jan 5, 2006
- Last updated
- Jul 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 048883 | GA | Primary |
Addresses
Primary practice location
111 Fairview Park Dr
Dublin, GA 31021-2501
Mailing address
PO Box 1528
Dublin, GA 31040-1528
Phone (478) 272-1366
Other practice location 1
677 Church St NE
Marietta, GA 30060-1101
Phone (470) 267-1760
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52420599-002 | Other | GA | BCBS |
| 4653853 | Other | GA | AETNA |
| 1007287 | Other | GA | UNITED HEALTHCARE |
| 681242 | Other | GA | FIRST HEALTH |
| 000872066A | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tcastillo524218@directwellstar.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048883 | GA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dublin Internal Medicine | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Dim Physicians LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients |
Locations
104 Fairview Park Dr
Dublin, GA 31021
Phone (478) 272-1366
200 Industrial Blvd
Dublin, GA 31021
Phone (478) 274-3865
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
Interoperability endpoints
- tirso.castillo@mrmc.gadirect.net
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.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
dba Dublin Internal Medicine
- Internal Medicine Physician
- Dublin, GA
- NPI 1457605867
-
- Internal Medicine Physician
- Dublin, GA
- NPI 1073618856
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1083692560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1528",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310401528",
"telephone_number": "478-272-1366",
"fax_number": "478-275-2322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 FAIRVIEW PARK DR",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310212501",
"telephone_number": "478-272-1366",
"fax_number": "478-275-2322"
}
],
"practiceLocations": [
{
"address_1": "677 Church St NE",
"address_purpose": "LOCATION",
"city": "Marietta",
"state": "GA",
"postal_code": "300601101",
"country_code": "US",
"telephone_number": "470-267-1760",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CASTILLO",
"first_name": "TIRSO",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "GA",
"license": "048883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "52420599-002",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4653853",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1007287",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "681242",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000872066A",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tcastillo524218@directwellstar.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "677 Church St NE",
"city": "Marietta",
"state": "GA",
"country_code": "US",
"postal_code": "300601101",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Dublin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.