Individual provider Active NPI

Georgina Polanco Castillo, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Raleigh, NC
National Provider Identifier
1578844775
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2020-0766 Issued in NC
Practice address
8340 Bandford Way Ste 1
Raleigh, NC 27615-2755
Phone
(919) 845-3332
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD2015-0855 NM
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2020-0766 NC Primary
Internal Medicine Physician 207R00000X 4301099326 MI

Addresses

Primary practice location

8340 Bandford Way Ste 1
Raleigh, NC 27615-2755

Mailing address

8340 Bandford Way
Ste 1
Raleigh, NC 27615-2755
Phone (919) 845-3332

Other identifiers 2

IdentifierTypeStateIssuer
05332044MedicaidNM
05332044MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200803002395 NC Practitioner - Endocrinology 6608005582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capital Endocrine Consultants, PAGroup PAC ID 4082706932, 14 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Merit-based Incentive Payment System (MIPS)

Final score
68.06 of 100Reported as group
Quality
40
Improvement activities
40
Cost
73.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-0766NCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Endocrine Consultants, PA CurrentSince Jan 2, 2021 Accepting new patients
Creedmoor Centre Endocrinology PA Internal Medicine PastSince Jul 12, 2020 Accepting new patients

Locations

3434 Edwards Mill Rd
Ste 112398
Raleigh, NC 27612
Phone (919) 878-1819

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3400 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 954-3000

Interoperability endpoints

  • Direct secure messaging: georgina.polancocastillo@ccendo.eclinicaldirectplus.com

Organizations & group practices 3

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 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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1578844775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 BANDFORD WAY",
            "address_2": "STE 1",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152755",
            "telephone_number": "919-845-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8340 BANDFORD WAY STE 1",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152755",
            "telephone_number": "919-845-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO CASTILLO",
        "first_name": "GEORGINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NM",
            "license": "MD2015-0855",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2020-0766",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301099326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05332044",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05332044",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.