Individual provider Active NPI

Ronald Joseph Castro Sr., M.D.

  • Gynecology Physician
  • Glendale, AZ
National Provider Identifier
1356320816
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
12701 Issued in AZ
Practice address
5422 W Thunderbird Rd
Suite 14-a
Glendale, AZ 85306-4700
Phone
(602) 843-1317
Fax
(602) 547-1430
NPI assigned
Jan 12, 2006
Last updated
Jul 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 12701 AZ Primary

Addresses

Primary practice location

5422 W Thunderbird Rd
Suite 14-a
Glendale, AZ 85306-4700

Mailing address

5422 W Thunderbird Rd
Suite 14-a
Glendale, AZ 85306-4700
Phone (602) 843-1317

Other identifiers 1

IdentifierTypeStateIssuer
210691-01MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20260430004233 AZ Order and Referring Only - General PracticePractitioner - General Practice 3971580069

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12701AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fountains Obstetrics & Gynecology, LTD Gynecology CurrentSince Sep 1, 2001 Accepting new patients

Locations

5620 W Thunderbird Rd
Ste C1
Glendale, AZ 85306
Phone (602) 843-1317

250 E Dunlap Ave
Phoenix, AZ 85020
Phone (480) 331-6721

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1356320816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5422 W THUNDERBIRD RD",
            "address_2": "SUITE 14-A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064700",
            "telephone_number": "602-843-1317",
            "fax_number": "602-547-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5422 W THUNDERBIRD RD",
            "address_2": "SUITE 14-A",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064700",
            "telephone_number": "602-843-1317",
            "fax_number": "602-547-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "RONALD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "12701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210691-01",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.