Sandra C. Castro, MD, FAAP, CHCQM

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01078458A Issued in IN

Practice address

350 S Landmark Ave
Bloomington, IN 47403-5001

Phone

(812) 335-2434

Fax

(812) 335-7604

NPI assigned

Jun 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Sandra Castro Walls Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Inphynet South Broward LLC

  • Emergency Medicine Physician
  • Hollywood, FL
  • NPI 1871521880
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1235165317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-335-2434",
            "fax_number": "812-335-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-335-2434",
            "fax_number": "812-335-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "SANDRA",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD, FAAP, CHCQM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01078458A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "07762",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049285000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235165317",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WALLS",
            "middle_name": "CASTRO",
            "prefix": "DR.",
            "credential": "MD, FAAP, CHCQM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cassandra McConn Inc
• Amy Casse
• Jericho A Castillo, PT
• Nathalie Castillo, MD
• Arturo D Castro Diaz, MD
• Nina Maria Castronova, LCSW, PHD
• Daniel E. Cates, PHD
• Catherine Crandall Counseling, LLC
• Catholic Charities
• Catozzi Corporation

• Pediatrics Physician in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.