Active NPI
Crystal Faith Castillo, PAC
- Physician Assistant
- Robbinsdale, MN
National Provider Identifier
1104872597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 10099
- Practice address
- 3300 Oakdale Ave N
Robbinsdale, MN 55422-2926 - Phone
- (763) 520-5330
- Fax
- (763) 520-2834
- NPI assigned
- May 26, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10099 | MN | Primary |
Addresses
Primary practice location
3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Mailing address
2800 Campus Dr #10
Plymouth, MN 55441-2645
Phone (763) 398-2203
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123659 | Other | MN | MEDICA |
| HP62370 | Other | FM | HEALTHPARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10099 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1104872597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 CAMPUS DR #10",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412645",
"telephone_number": "763-398-2203",
"fax_number": "763-398-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 OAKDALE AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554222926",
"telephone_number": "763-520-5330",
"fax_number": "763-520-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASTILLO",
"first_name": "CRYSTAL",
"middle_name": "FAITH",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "10099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0123659",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP62370",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.