Individual provider Active NPI

Raymond M De Castro, MD

  • Psychiatry Physician
  • Orange City, FL
National Provider Identifier
1104015932
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D0026528 Issued in MD
Practice address
135 E Minnesota Ave
Orange City, FL 32763-2312
Phone
(386) 241-0274
Fax
(386) 241-0275
NPI assigned
Oct 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 16737 FL
Psychiatry Physician 2084P0800X D0026528 MD Primary

Addresses

Primary practice location

135 E Minnesota Ave
Orange City, FL 32763-2312

Mailing address

341 W Minnesota Ave
Orange City, FL 32763-2205
Phone (863) 241-0274

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
I20170124002483 FL Practitioner - Psychiatry 4082996210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Health Care Plan IncGroup PAC ID 9436201233, 97 clinicians

Practice addresses (Care Compare)

110 Pond CT
Suite 201
Debary, FL 32713-2717
Phone (386) 317-8635

740 Dunlawton Ave
Suite 200
Port Orange, FL 32127-4240
Phone (386) 763-1000

Hospital & facility affiliations

  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0026528MDMDPsychiatry Physician
16737FLMDPrimary Care Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Dec 5, 2016 Accepting new patients
Home Docs CurrentSince May 14, 2019 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Dec 5, 2016 Accepting new patients

Locations

135 E Minnesota Ave
Orange City, FL 32763
Phone (386) 241-0274

740 Dunlawton Ave
Ste 200
Port Orange, FL 32127
Phone (386) 763-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24896/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1104015932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 W MINNESOTA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327632205",
            "telephone_number": "863-241-0274",
            "fax_number": "808-433-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E MINNESOTA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327632312",
            "telephone_number": "386-241-0274",
            "fax_number": "386-241-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "RAYMOND",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "16737",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "D0026528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.