NPIMap

Individual provider Active NPI

Michelle Castro, OTD, OTR/L

  • Pediatric Occupational Therapist
  • San Bernardino, CA
National Provider Identifier
1194136572
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
13827 Issued in CA
Practice address
1499 S Tippecanoe Ave # a
San Bernardino, CA 92408-2920
Phone
(909) 799-3777
NPI assigned
May 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 13827 CA Primary
Occupational Therapist 225X00000X 13827 CA

Addresses

Primary practice location

1499 S Tippecanoe Ave # a
San Bernardino, CA 92408-2920

Mailing address

1499 S Tippecanoe Ave # a
San Bernardino, CA 92408-2920
Phone (909) 799-3777

Other practice location 1

620 N Lake Ave
Pasadena, CA 91101-1220
Phone (626) 793-7350 ext. 230

Other identifiers 1

IdentifierTypeStateIssuer
1194136572OtherCAINDIVIDUAL

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.autismassessment4ie.org/

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Empire Autism Spectrum Disorder Assessment Center of Excellence Occupational Therapist PastSince Aug 6, 2023 Accepting new patients
Inland Empire Autism Assessment Center, a Psychological Corporation Occupational Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1194136572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 S TIPPECANOE AVE # A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082920",
            "telephone_number": "909-799-3777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 S TIPPECANOE AVE # A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082920",
            "telephone_number": "909-799-3777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Lake Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911011220",
            "country_code": "US",
            "telephone_number": "626-793-7350 x230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "MICHELLE",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "13827",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "13827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1194136572",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.autismassessment4ie.org/",
            "affiliation": "N",
            "address_1": "1499 S Tippecanoe Ave # A",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924082920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.