Individual provider Active NPI

Fausto J Castillo Mairena, M.D.

  • Family Medicine Physician
  • Visalia, CA
National Provider Identifier
1780115972
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A163451 Issued in CA
Practice address
5405 W Hillsdale Ave
Visalia, CA 93291-5156
Phone
(559) 556-5591
Fax
(888) 720-1716
NPI assigned
Mar 21, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A163451 CA Primary

Addresses

Primary practice location

5405 W Hillsdale Ave
Visalia, CA 93291-5156

Mailing address

5405 W Hillsdale Ave
Visalia, CA 93291-5156
Phone (559) 556-5591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201217001850 CA Practitioner - Family Practice 2264856616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5405 W Hillsdale Ave
Visalia, CA 93291-5156
Phone (559) 556-5591

Hospital & facility affiliations

  • Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A163451CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practicalmed Inc Single Specialty CurrentSince Feb 27, 2023 Accepting new patients
Reedley Community Hospital Past Accepting new patients
Hanford Community Hospital Single Specialty Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Kaweah Delta Health Care District Past Accepting new patients

Locations

5405 W Hillsdale Ave
Visalia, CA 93291
Phone (559) 556-5591

Interoperability endpoints

  • Direct secure messaging: faustoj.castillo@524535353507844.direct.elationemr.com

Organizations & group practices 5

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 1

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1780115972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 W HILLSDALE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915156",
            "telephone_number": "559-556-5591",
            "fax_number": "559-863-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 W HILLSDALE AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932915156",
            "telephone_number": "559-556-5591",
            "fax_number": "888-720-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO MAIRENA",
        "first_name": "FAUSTO J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-21",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A163451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.