Individual provider Active NPI

Fermin Cruz Castellanos, AGACNP-AG

  • Acute Care Nurse Practitioner
  • Palestine, TX
National Provider Identifier
1669200473
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1169544 Issued in TX
Practice address
300 Willow Creek Pkwy Ste 200
Palestine, TX 75801-4433
Phone
(903) 221-0138
Fax
(903) 221-0137
NPI assigned
Jul 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1169544 TX Primary

Addresses

Primary practice location

300 Willow Creek Pkwy Ste 200
Palestine, TX 75801-4433

Mailing address

1004 W Reagan St
Palestine, TX 75801-2276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20250121002694 TX Practitioner - Nurse Practitioner 1951830900 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restrata Health Group PLLCGroup PAC ID 3971032996, 3 clinicians
Pallicare, IncGroup PAC ID 8123429925, 85 clinicians

Practice addresses (Care Compare)

300 Willow Creek Pkwy
Suite 200
Palestine, TX 75801-4433
Phone (903) 221-0138

5803 Stoneridge Dr
Texarkana, TX 75503-1461
Phone (903) 278-5747

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pallicare, Inc CurrentSince Feb 19, 2026 Accepting new patients
Restrata Health Group PLLC Current Accepting new patients

Locations

300 Willow Creek Pkwy
Ste 200
Palestine, TX 75801
Phone (903) 221-0138

703 S Mill St
Winnsboro, TX 75494
Phone (903) 342-5261

Interoperability endpoints

  • Direct secure messaging: fermin.cruz.castellanos.1@15408.direct.athenahealth.com
  • Direct secure messaging: fercruz@tfhc.kareodirect.com
  • Direct secure messaging: fermin.cruz.castellanos.1@34366.direct.athenahealth.com

Organizations & group practices 3

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1669200473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 W REAGAN ST",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758012276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 WILLOW CREEK PKWY STE 200",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014433",
            "telephone_number": "903-221-0138",
            "fax_number": "903-221-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ CASTELLANOS",
        "first_name": "FERMIN",
        "credential": "AGACNP-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1169544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.