Individual provider Active NPI

Rae Ann Castillo

  • Acute Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1417365784
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
95001011 Issued in CA
Practice address
1500 San Pablo St FL 7
Los Angeles, CA 90033-5313
Phone
(323) 442-6254
NPI assigned
Jul 30, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Clinical Nurse Specialist 364SA2100X 4164 CA
Acute Care Nurse Practitioner 363LA2100X 95001011 CA Primary

Addresses

Primary practice location

1500 San Pablo St FL 7
Los Angeles, CA 90033-5313

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (626) 457-6601

Other practice location 1

5153 Mount Helena Ave
Los Angeles, CA 90041-2330
Phone (323) 257-8399

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address raeann.castillo@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20221026001070 CA Practitioner - Nurse Practitioner 6305212739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

301 S Fair Oaks Ave
Suite 304
Pasadena, CA 91105-2562
Phone (877) 448-3627

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2022 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Sep 1, 2022 Accepting new patients
Mark H Mazur MD & Barry Statner MD a Professional Corporation CurrentSince Dec 8, 2025 Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

2360 E Bidwell St
Ste 107
Folsom, CA 95630
Phone (916) 220-2951

4980 Barranca Pkwy
Ste 195
Irvine, CA 92604
Phone (949) 398-5280

4037 Hardwick St
Lakewood, CA 90712

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1500 San Pablo St
Fl 7
Los Angeles, CA 90033
Phone (323) 409-7761

1520 San Pablo St
Ste 4100
Los Angeles, CA 90033
Phone (323) 442-6000

1174 Castro St
Ste 150
Mountain View, CA 94040

24640 Jefferson Ave
Ste 208
Murrieta, CA 92562
Phone (951) 395-5457

301 S Fair Oaks Ave
Ste 304
Pasadena, CA 91105
Phone (626) 960-2711

15706 Pomerado Rd
Ste S202
Poway, CA 92064

24355 Lyons Ave
Ste 160
Santa Clarita, CA 91321
Phone (661) 600-9494

2220 Lynn Rd
Ste 301
Thousand Oaks, CA 91360
Phone (805) 495-1073

375 Rolling Oaks Dr
Ste 210
Thousand Oaks, CA 91361
Phone (805) 495-1073

130 La Casa Via
Ste 108
Walnut Creek, CA 94598

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1417365784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "626-457-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SAN PABLO ST FL 7",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900335313",
            "telephone_number": "323-442-6254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5153 Mount Helena Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900412330",
            "country_code": "US",
            "telephone_number": "323-257-8399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "RAE ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-30",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "CA",
            "license": "4164",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95001011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "raeann.castillo@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1520 San Pablo St",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.