Individual provider Active NPI

Noel David Castro

  • Physician Assistant
  • Syracuse, NY
National Provider Identifier
1104653666
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
819 S Salina St
Syracuse, NY 13202-3570
Phone
(315) 476-7921
NPI assigned
Sep 18, 2024
Last updated
Sep 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 NY Primary

Addresses

Primary practice location

819 S Salina St
Syracuse, NY 13202-3570

Mailing address

819 S Salina St
Syracuse, NY 13202-3570
Phone (315) 476-7921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20241112001057 NY Practitioner - Physician Assistant 6002340148 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
032669NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Syracuse Community Health Center, Inc. PastSince Jun 9, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ncastro747472@direct.ochin.org

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": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1104653666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023570",
            "telephone_number": "315-476-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S SALINA ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023570",
            "telephone_number": "315-476-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "NOEL",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.