Individual provider Active NPI

Andrew Douglas Kastello, M.D.

  • Trauma Surgery Physician
  • Carbondale, IL
National Provider Identifier
1578720629
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
2086S0127X Issued in IL
Practice address
305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone
(618) 457-3006
Fax
(618) 457-3007
NPI assigned
May 16, 2008
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 72354 GA
Surgery Physician 208600000X 036171933 IL
Surgical Critical Care Physician 2086S0102X 72354 GA
Surgical Critical Care Physician 2086S0102X 036171933 IL
Trauma Surgery Physician 2086S0127X 2086S0127X IL Primary

Addresses

Primary practice location

305 W Jackson St Ste 206
Carbondale, IL 62901-1474

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

3647 J Dewey Gray Cir Ste 200
Augusta, GA 30909-2205
Phone (706) 504-9712

Other practice location 2

220 S Park Ave Fl 3
Herrin, IL 62948-3602
Phone (618) 942-2002

Other practice location 3

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 351-7300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address akastello77555@sih.direct-ci.com
Direct Messaging Address akastello77555@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191226001809 MD Practitioner - General Surgery 4789717356 Reassigns benefits to 3 organizations
I20241031002412 IL Practitioner - General Surgery 4789717356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

305 W Jackson St
Suite 206
Carbondale, IL 62901-1474
Phone (618) 457-3006

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72354GAMDSurgery Physician
036171933ILMDSurgery Physician
2086S0127XILMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Atlantic Surgical Group Surgery CurrentSince Feb 3, 2020 Accepting new patients
Trauma Surgical Assoc Surgical Critical Care CurrentSince Feb 3, 2020 Accepting new patients
Healogics Specialty Physicians of Maryland, LLC CurrentSince May 11, 2021 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Oct 28, 2024 Accepting new patients
Burn and Reconstructive Centers of Virginia, PLLC PastSince Nov 8, 2020 Accepting new patients
Cumberland Plateau General Surgery, PLLC Surgery PastSince Jun 25, 2010 Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

220 S Park Ave
Fl 3
Herrin, IL 62948
Phone (618) 942-2002

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

6507 Deer Pointe Dr
Salisbury, MD 21804
Phone (410) 543-9332

Interoperability endpoints

  • Direct secure messaging: akastello77555@sih.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1210896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1578720629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 206",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3647 J Dewey Gray Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309092205",
            "country_code": "US",
            "telephone_number": "706-504-9712",
            "fax_number": "706-504-9703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 S Park Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483602",
            "country_code": "US",
            "telephone_number": "618-942-2002",
            "fax_number": "618-351-6497",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-351-7300",
            "fax_number": "618-457-7890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASTELLO",
        "first_name": "ANDREW",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-16",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "72354",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036171933",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "72354",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036171933",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": "2086S0127X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akastello77555@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 206",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akastello77555@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "220 S Park Ave Fl 3",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.