NPIMap

Individual provider Active NPI

Martin Daniel Castillo, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1588007249
Registry record updated Jun 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP07248 Issued in LA
Practice address
1717 Oak Park Blvd
3Rd FL
Lake Charles, LA 70601-8991
Phone
(337) 475-8100
Fax
(337) 475-8510
NPI assigned
Apr 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP07248 LA Primary

Addresses

Primary practice location

1717 Oak Park Blvd
3Rd FL
Lake Charles, LA 70601-8991

Mailing address

PO Box 122108
Dept 2108
Dallas, TX 75312-2108
Phone (337) 494-2919

Other identifiers 1

IdentifierTypeStateIssuer
2336355MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130503000183 LA Practitioner - Nurse Practitioner 2264679638 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

401 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5864
Phone (337) 436-6100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP07248LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Louisiana Hospital Association Inc CurrentSince Oct 1, 2017 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients
Southwest Louisiana Hospital Association Inc CurrentSince Oct 1, 2017 Accepting new patients
Ochsner Clinic LLC CurrentSince Apr 22, 2019 Accepting new patients
Ochsner Clinic LLC CurrentSince Apr 22, 2019 Accepting new patients
Professional Emergency Medicine Management -- Lake Charles LLC CurrentSince May 10, 2015 Accepting new patients
Calcasieu Cameron Emergency Physician Group LLC CurrentSince May 22, 2015 Accepting new patients
Ochsner Clinic LLC PastSince Oct 27, 2019 Accepting new patients

Locations

1636 Elton Rd
Jennings, LA 70546
Phone (337) 656-7770

1000 Walters St
Lake Charles, LA 70607
Phone (337) 475-8687

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

401 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 436-6100

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

Interoperability endpoints

  • Direct secure messaging: mcastillo517485@direct.ochsner.org

Organizations & group practices 8

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1588007249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122108",
            "address_2": "DEPT 2108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122108",
            "telephone_number": "337-494-2919",
            "fax_number": "337-494-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD",
            "address_2": "3RD FL",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018991",
            "telephone_number": "337-475-8100",
            "fax_number": "337-475-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "MARTIN",
        "middle_name": "DANIEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2336355",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.