Individual provider Active NPI

Marina Ortiz Castillo, MD

  • Pediatrics Physician
  • Stockton, CA
National Provider Identifier
1548406143
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A97137 Issued in CA
Practice address
701 E Channel St
Stockton, CA 95202-2628
Phone
(209) 944-4700
Fax
(209) 373-2873
NPI assigned
Jan 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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 A97137 CA Primary

Addresses

Primary practice location

701 E Channel St
Stockton, CA 95202-2628

Mailing address

1300 W Lodi Ave Ste P
Lodi, CA 95242-3038
Phone (209) 369-7493

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000238 CA Practitioner - Pediatric Medicine 2264677350 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A97137CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Pediatrics CurrentSince Nov 12, 2018 Accepting new patients
Sutter Valley Medical Foundation Pediatrics Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Nov 12, 2018 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
St. Joseph'S Hospital, Yonkers Past Accepting new patients
County of San Joaquin Past Accepting new patients

Locations

1300 W Lodi Ave
Ste P
Lodi, CA 95242
Phone (209) 366-1990

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: mcastillo217787@hisp.ehr.sutterhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1548406143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE STE P",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423038",
            "telephone_number": "209-369-7493",
            "fax_number": "209-369-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E CHANNEL ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022628",
            "telephone_number": "209-944-4700",
            "fax_number": "209-373-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "MARINA",
        "middle_name": "ORTIZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-02",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.