Individual provider Active NPI

Carreen Castroll, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Coram, NY
National Provider Identifier
1639313398
Registry record updated Apr 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F401197 Issued in NY
Practice address
3600 Route 112
Coram, NY 11727-4116
Phone
(631) 920-8500
Fax
(631) 920-8501
NPI assigned
Apr 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X F401197 NY Primary

Addresses

Primary practice location

3600 Route 112
Coram, NY 11727-4116

Mailing address

3600 Route 112
Coram, NY 11727-4116
Phone (631) 920-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190328001702 NY Practitioner - Nurse Practitioner 7810237831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Psychiatric Consultants PCGroup PAC ID 1456240928, 8 clinicians

Practice addresses (Care Compare)

222 E Middle Country Rd
Suite 210
Smithtown, NY 11787-2814
Phone 6312656868210

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F401197NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Psychiatric Consultants PC CurrentSince Apr 21, 2019 Accepting new patients

Locations

222 E Middle Country Rd
Ste 210
Smithtown, NY 11787
Phone (631) 265-6868

180 E Main St
Ste 302
Smithtown, NY 11787
Phone (631) 265-6868

Organizations & group practices 1

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": "1240617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240617600000",
    "number": "1639313398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8500",
            "fax_number": "631-920-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 112",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117274116",
            "telephone_number": "631-920-8500",
            "fax_number": "631-920-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTROLL",
        "first_name": "CARREEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-25",
        "last_updated": "2009-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F401197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coram, NY

Sources for this page

Verify at the official NPI Registry.