Individual provider Active NPI

Michelle Amaya Castor, DO

  • Pediatrics Physician
  • Tulsa, OK
National Provider Identifier
1255994414
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
6938 Issued in OK
Practice address
12020 E 31St St
Tulsa, OK 74146-2001
Phone
(918) 622-4814
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 6938 OK Primary

Addresses

Primary practice location

12020 E 31St St
Tulsa, OK 74146-2001

Mailing address

12020 E 31St St
Tulsa, OK 74146-2001
Phone (918) 622-4814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20221026000120 OK Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3072989482

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6938OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Hospital, Inc. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1255994414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12020 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741462001",
            "telephone_number": "918-622-4814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741462001",
            "telephone_number": "918-622-4814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTOR",
        "first_name": "MICHELLE",
        "middle_name": "AMAYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.