Individual provider Active NPI

Jose M Del Castillo, DO

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1265977995
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SL2166 Issued in NV
Practice address
700 Shadow LN Ste 400
Las Vegas, NV 89106-4159
Phone
(435) 256-5904
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SL2166 NV Primary

Addresses

Primary practice location

700 Shadow LN Ste 400
Las Vegas, NV 89106-4159

Mailing address

70 E Mulberry LN
Leeds, UT 84746-7768
Phone (435) 256-5904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240819003406 NV Order and Referring Only - Family PracticePractitioner - Family Practice 3870031032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SL2166NVMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1265977995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E MULBERRY LN",
            "city": "LEEDS",
            "state": "UT",
            "postal_code": "847467768",
            "telephone_number": "435-256-5904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHADOW LN STE 400",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891064159",
            "telephone_number": "435-256-5904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL CASTILLO",
        "first_name": "JOSE",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2024-05-23",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "SL2166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.