Individual provider Active NPI

Juan Pedro Castellanos, MD

  • General Practice Physician
  • Hialeah, FL
National Provider Identifier
1417030271
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME35759 Issued in FL
Practice address
2140 W 68TH St
Suite 202
Hialeah, FL 33016-1815
Phone
(305) 820-4080
Fax
(305) 820-4080
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME35759 FL Primary

Addresses

Primary practice location

2140 W 68TH St
Suite 202
Hialeah, FL 33016-1815

Mailing address

2140 W 68TH St
Suite 202
Hialeah, FL 33016-1815
Phone (305) 820-4080

Other identifiers 1

IdentifierTypeStateIssuer
065312800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME35759FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madeleine Castellanos DMD PLLC PastSince Jan 17, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1417030271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 202",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-820-4080",
            "fax_number": "305-820-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W 68TH ST",
            "address_2": "SUITE 202",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161815",
            "telephone_number": "305-820-4080",
            "fax_number": "305-820-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANOS",
        "first_name": "JUAN",
        "middle_name": "PEDRO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME35759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065312800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.