Individual provider Active NPI

Maria Rosario Castellon, P.A.-C

  • Physician Assistant
  • Sherman Oaks, CA
National Provider Identifier
1306003272
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14427 Issued in CA
Practice address
4955 Van Nuys Blvd Ste 200
Sherman Oaks, CA 91403-1814
Phone
(818) 981-1555
NPI assigned
May 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14427 CA Primary

Addresses

Primary practice location

4955 Van Nuys Blvd Ste 200
Sherman Oaks, CA 91403-1814

Mailing address

4955 Van Nuys Blvd Ste 200
Sherman Oaks, CA 91403-1814
Phone (818) 981-1555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20040430001379 CA Practitioner - Physician Assistant 4183612021

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shahryar Manavi M D Inc CurrentSince Jun 1, 2014 Accepting new patients

Locations

214 N Central Ave
Glendale, CA 91203
Phone (818) 241-0970

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1306003272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031814",
            "telephone_number": "818-981-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 VAN NUYS BLVD STE 200",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031814",
            "telephone_number": "818-981-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLON",
        "first_name": "MARIA",
        "middle_name": "ROSARIO",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.