Active NPI
Carlos Anthony Castro, MSW
- Psychiatric/Mental Health Nurse Practitioner
- San Bernardino, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 95022963
- Practice address
- 742 W Highland Ave
San Bernardino, CA 92405-3839 - Phone
- (909) 881-7320
- Fax
- (909) 881-7330
- NPI assigned
- Feb 8, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN95235553 | CA | |
| Clinical Social Worker | 1041C0700X | 79451 | CA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95022963 | CA | Primary |
Addresses
Primary practice location
742 W Highland Ave
San Bernardino, CA 92405-3839
Mailing address
742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320
Other practice location 1
303 E Vanderbilt Way
San Bernardino, CA 92415-5230
Phone (909) 386-8239
Other practice location 2
1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
11147 Tamarisk Rd
Adelanto, CA 92301-3623
742 W Highland Ave
San Bernardino, CA 92405-3839
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79451 | CA | MD | Clinical Social Worker |
| RN95235553 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Marcos Medical Group Inc | Current | Accepting new patients |
Locations
7965 Sierra Ave
Ste E
Fontana, CA 92336
Phone (909) 356-4459
14980 Summit Ave
Ste 230
Fontana, CA 92336
Phone (909) 803-1160
742 W Highland Ave
Sn Bernrdno, CA 92405
Phone (909) 881-7320
Interoperability endpoints
- carlos.castro.p1@direct.metro.nextgenshare.com
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 and National Provider Directory roles.
-
dba Summit Family Health Center
- Obstetrics & Gynecology Physician
- Fontana, CA
- NPI 1447446448
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1205976941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "742 W HIGHLAND AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924053839",
"telephone_number": "909-881-7320",
"fax_number": "909-881-7330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "742 W HIGHLAND AVE",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924053839",
"telephone_number": "909-881-7320",
"fax_number": "909-881-7330"
}
],
"practiceLocations": [
{
"address_1": "303 E Vanderbilt Way",
"address_purpose": "LOCATION",
"city": "San Bernardino",
"state": "CA",
"postal_code": "924155230",
"country_code": "US",
"telephone_number": "909-386-8239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 Hughes Way Ste 150",
"address_purpose": "LOCATION",
"city": "Long Beach",
"state": "CA",
"postal_code": "908101878",
"country_code": "US",
"telephone_number": "310-221-6336",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CASTRO",
"first_name": "CARLOS",
"middle_name": "ANTHONY",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "RN95235553",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "79451",
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "CA",
"license": "95022963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Sep 30, 2024; 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.