Individual provider Active NPI

Laura Elizabeth Castro

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1477040822
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
66746 Issued in AZ
Practice address
15650 N Black Canyon Hwy
Ste 100
Phoenix, AZ 85053
Phone
(602) 866-0550
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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 66746 AZ Primary

Addresses

Primary practice location

15650 N Black Canyon Hwy
Ste 100
Phoenix, AZ 85053

Mailing address

15650 N Black Canyon Hwy Ste 100
Phoenix, AZ 85053-4068
Phone (602) 866-0550

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

State licenses

LicenseStateTypeSpecialty
66746AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Group Specialists, LTD. Pediatrics CurrentSince Dec 13, 2022 Accepting new patients

Locations

15650 N Black Canyon Hwy
Ste 100
Phoenix, AZ 85053
Phone (602) 866-0550

15650 N Black Canyon Hwy
Phoenix, AZ 85053
Phone (602) 284-4555

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1477040822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15650 N BLACK CANYON HWY STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534068",
            "telephone_number": "602-866-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15650 N BLACK CANYON HWY",
            "address_2": "STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "602-866-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "66746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.