Individual provider Active NPI

Thais Melissa Castillo, M.D.

  • Pediatrics Physician
  • New York, NY
National Provider Identifier
1457646358
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
NO LICENSE Issued in NY
Practice address
462 1St Ave
Department of Pediatrics
New York, NY 10016-9196
Phone
(212) 263-7822
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NO LICENSE NY Primary

Addresses

Primary practice location

462 1St Ave
Department of Pediatrics
New York, NY 10016-9196

Mailing address

462 1St Ave
Department of Pediatrics
New York, NY 10016-9196
Phone (212) 263-7822

Other identifiers 1

IdentifierTypeStateIssuer
091892OtherNYMDID

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130920000338 NY Practitioner - Pediatric Medicine 3779727326 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NO LICENSENYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Mar 5, 2015 Accepting new patients
Montefiore Medical Center CurrentSince Mar 5, 2015 Accepting new patients

Locations

2100 Bartow Ave
Bronx, NY 10475
Phone (718) 320-5300

111 E 210th St
Bronx, NY 10467

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308528000000",
    "number": "1457646358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-263-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "address_2": "DEPARTMENT OF PEDIATRICS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-263-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "THAIS",
        "middle_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2011-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "NO LICENSE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDID",
            "identifier": "091892",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.