Individual provider Active NPI

Lisa Jun Castaneda, MD

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1639596190
Registry record updated Aug 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ML60466576 Issued in WA
Practice address
1959 NE Pacific St RM BB-527
Box 356421
Seattle, WA 98195-6421
Phone
(206) 543-3605
NPI assigned
Mar 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ML60466576 WA Primary

Addresses

Primary practice location

1959 NE Pacific St RM BB-527
Box 356421
Seattle, WA 98195-6421

Mailing address

1959 NE Pacific St RM BB-527
Box 356421
Seattle, WA 98195-6421
Phone (206) 543-3605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WA2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170907003759 SD Practitioner - Internal Medicine 0446575195 Reassigns benefits to 1 organization
I20191017000952 WA Practitioner - Internal Medicine 0446575195 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML60466576WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians, PLLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Network, Inc. CurrentSince Aug 1, 2017 Accepting new patients
Monument Health Network, Inc. CurrentSince Aug 1, 2017 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

Interoperability endpoints

  • Direct secure messaging: lcastaneda420216@direct.peacehealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408233600000",
    "number": "1639596190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST RM BB-527",
            "address_2": "BOX 356421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956421",
            "telephone_number": "206-543-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST RM BB-527",
            "address_2": "BOX 356421",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956421",
            "telephone_number": "206-543-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "LISA",
        "middle_name": "JUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-23",
        "last_updated": "2014-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "ML60466576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.