Individual provider Active NPI

Jodi Castleberry, PA-C

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1215485461
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6452 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(480) 301-8000
NPI assigned
Sep 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6452 AZ
Physician Assistant 363A00000X 6452 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Other practice location 1

9159 W Thunderbird Rd
Peoria, AZ 85381-4910
Phone (623) 933-7453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200128001485 AZ Practitioner - Physician Assistant 0648606335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.47 of 100Reported as group
Quality
78.27
Promoting interoperability
100
Improvement activities
40
Cost
76.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6452AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Arizona CurrentSince Jan 20, 2020 Accepting new patients
Mayo Clinic Arizona CurrentSince Jan 20, 2020 Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

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": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1215485461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9159 W Thunderbird Rd",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853814910",
            "country_code": "US",
            "telephone_number": "623-933-7453",
            "fax_number": "623-974-3870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTLEBERRY",
        "first_name": "JODI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-16",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6452",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.