Organization Active NPI

Evangelina Castaneda M.D., P.a.

  • Endocrinology, Diabetes & Metabolism Physician
  • Plano, TX
National Provider Identifier
1669667788
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
G2341 Issued in TX
Legal business name
EVANGELINA CASTANEDA M.D., P.A.
Practice address
4100 W 15TH St
Suite 118
Plano, TX 75093-5803
Phone
(972) 985-1312
Fax
(972) 596-7192
NPI assigned
Sep 11, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Dr. Evangelina Castanedada, M.D.
Title
Owner/President
Phone
(972) 985-1312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X G2341 TX Primary

Addresses

Primary practice location

4100 W 15TH St
Suite 118
Plano, TX 75093-5803

Mailing address

4100 W 15TH St
Suite 118
Plano, TX 75093-5803
Phone (972) 985-1312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120329000129 TX Part B Supplier - Clinic/Group Practice 1759541758 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Locations

4100 W 15th St
Ste 118
Plano, TX 75093
Phone (972) 985-1312

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1669667788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W 15TH ST",
            "address_2": "SUITE 118",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935803",
            "telephone_number": "972-985-1312",
            "fax_number": "972-596-7192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 15TH ST",
            "address_2": "SUITE 118",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935803",
            "telephone_number": "972-985-1312",
            "fax_number": "972-596-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANGELINA CASTANEDA M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "CASTANEDADA",
        "authorized_official_first_name": "EVANGELINA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "972-985-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "G2341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.