Individual provider Active NPI

Jason Casto, D.C.

  • Chiropractor
  • South Lake Tahoe, CA
National Provider Identifier
1407146921
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28633 Issued in CA
Practice address
1156 Emerald Bay Rd
Building C
South Lake Tahoe, CA 96150-6157
Phone
(530) 543-1801
Fax
(530) 543-1322
NPI assigned
Apr 18, 2011
Last updated
Apr 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28633 CA Primary

Addresses

Primary practice location

1156 Emerald Bay Rd
Building C
South Lake Tahoe, CA 96150-6157

Mailing address

15550 Rockfield Blvd Ste B220
Irvine, CA 92618-6703
Phone (949) 598-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040916001303 CA Practitioner - Chiropractic 3678541778 Practice locations: South Lake Tahoe, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC28633CAMDChiropractor
28633CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Casto Chiropractic Inc Chiropractor PastSince Feb 21, 2010 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, 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": "1303084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303084800000",
    "number": "1407146921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD STE B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926186703",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 EMERALD BAY RD",
            "address_2": "BUILDING C",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506157",
            "telephone_number": "530-543-1801",
            "fax_number": "530-543-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTO",
        "first_name": "JASON",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-18",
        "last_updated": "2011-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.