Individual provider Active NPI

Emily Berniece Castillo, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1659164341
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013185 Issued in MI
Practice address
2121 Spring Arbor Rd
Jackson, MI 49203-2707
Phone
(517) 787-5350
NPI assigned
May 26, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013185 MI Primary

Addresses

Primary practice location

2121 Spring Arbor Rd
Jackson, MI 49203-2707

Mailing address

9683 Fawn Run
Brighton, MI 48114-7541

Other practice location 1

7070 E Dr N
Battle Creek, MI 49014-8562
Phone (269) 660-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250904001010 MI Practitioner - Physician Assistant 7113429754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Skin Surgery CenterGroup PAC ID 2668467838, 29 clinicians

Practice addresses (Care Compare)

2121 Spring Arbor Rd
Jackson, MI 49203-2707
Phone (517) 787-5350

7070 E Dr N
Battle Creek, MI 49014-8562
Phone (269) 660-1670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601013185MIMDPhysician Assistant

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": "1748217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1659164341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9683 FAWN RUN",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SPRING ARBOR RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492032707",
            "telephone_number": "517-787-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7070 E Dr N",
            "address_purpose": "LOCATION",
            "city": "Battle Creek",
            "state": "MI",
            "postal_code": "490148562",
            "country_code": "US",
            "telephone_number": "269-660-1670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "EMILY",
        "middle_name": "BERNIECE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-26",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.