Individual provider Active NPI

Mario Castillo-Sang, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Edgewood, KY
National Provider Identifier
1225293418
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
51353 Issued in KY
Practice address
711 Medical Village Dr
Edgewood, KY 41017
Phone
(859) 301-9010
Fax
(859) 301-9018
NPI assigned
Jul 28, 2008
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2010003180 MO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 35126643 OH
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 34641 SC
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2010003180 MO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 51353 KY Primary

Addresses

Primary practice location

711 Medical Village Dr
Edgewood, KY 41017

Mailing address

PO Box 636324
Cincinnati, OH 45263-6324
Phone (859) 301-9010

Other practice location 1

2123 Auburn Ave
Su. 139
Cincinnati, OH 45219-2906
Phone (513) 206-1170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806001755 KY Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 5799932075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

200 Medical Village Dr
Edgewood, KY 41017-3408
Phone (859) 301-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010003180MOMDSurgery Physician
34641SCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Elizabeth Medical Center, Inc CurrentSince Mar 2, 2020 Accepting new patients
St. Elizabeth Medical Center, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 2, 2020 Accepting new patients
St Elizabeth Medical Center, Inc Surgery Current Accepting new patients
The Christ Hospital Medical Associates, LLC PastSince Aug 1, 2018 Accepting new patients
Ohio Heart and Vascular Center, Inc PastSince Oct 1, 2015 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

20 Medical Village Dr
Edgewood, KY 41017
Phone (859) 344-1600

20 Medical Village Dr
Ste 204
Edgewood, KY 41017
Phone (859) 301-5959

200 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-5900

711 Medical Village Dr
Edgewood, KY 41017
Phone (859) 287-3045

Interoperability endpoints

  • Direct secure messaging: mcastillosang315124@direct-prd.stelizabeth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1225293418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636324",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636324",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-301-9010",
            "fax_number": "859-301-9018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2123 Auburn Ave",
            "address_2": "Su. 139",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452192906",
            "country_code": "US",
            "telephone_number": "513-206-1170",
            "fax_number": "513-206-1172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO-SANG",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2010003180",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "OH",
            "license": "35126643",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "34641",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2010003180",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KY",
            "license": "51353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.