Active NPI
Ryan Lee Kastern, MPAS, PA-C
- Physician Assistant
- Jbsa Lackland, TX
National Provider Identifier
1588857882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1077670
- Practice address
- 1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638 - Phone
- (210) 671-6064
- NPI assigned
- Aug 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1077670 | FL | Primary |
Addresses
Primary practice location
1100 Wilford Hall Loop
Jbsa Lackland, TX 78236-5638
Mailing address
1100 Wilford Hall Loop BLDG 4554
Jbsa Lackland, TX 78236-5638
Phone (210) 671-6064
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1077670 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562544000000",
"number": "1588857882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP BLDG 4554",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-671-6064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD HALL LOOP",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "782365638",
"telephone_number": "210-671-6064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASTERN",
"first_name": "RYAN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "MPAS, PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-21",
"last_updated": "2019-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "1077670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.