Individual provider Active NPI

Maria Lola Castro-Jimenez, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Spencerport, NY
National Provider Identifier
1396212015
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F308783-1 Issued in NY
Practice address
42 Nichols St Ste 10
Spencerport, NY 14559-2196
Phone
(585) 637-7558
Fax
(585) 637-7566
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 308783 NY
Adult Health Nurse Practitioner 363LA2200X F308783-1 NY Primary

Addresses

Primary practice location

42 Nichols St Ste 10
Spencerport, NY 14559-2196

Mailing address

42 Nichols St Ste 10
Spencerport, NY 14559-2196
Phone (585) 637-7558

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mcastrojimenez79290@direct.urmc.rochester.edu Direct
Direct Messaging Address mcastrojimenez79290@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190110002322 NY Practitioner - Nurse Practitioner 0244576353 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
308783NYMDAdult Health Nurse Practitioner
F308783-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Dec 15, 2018 Accepting new patients
University of Rochester CurrentSince Dec 15, 2018 Accepting new patients

Locations

2400 S Clinton Ave
#H
Rochester, NY 14618
Phone (585) 341-7299

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

42 Nichols St
Ste 10
Spencerport, NY 14559
Phone (585) 349-7094

Organizations & group practices 2

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": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1396212015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 NICHOLS ST STE 10",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592196",
            "telephone_number": "585-637-7558",
            "fax_number": "585-637-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NICHOLS ST STE 10",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145592196",
            "telephone_number": "585-637-7558",
            "fax_number": "585-637-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO-JIMENEZ",
        "first_name": "MARIA",
        "middle_name": "LOLA",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "308783",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F308783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcastrojimenez79290@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcastrojimenez79290@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spencerport, NY

Sources for this page

Verify at the official NPI Registry.