Individual provider Active NPI

Mark Christopher De Castro, DPT

  • Physical Therapist
  • Escondido, CA
National Provider Identifier
1780212092
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT298331 Issued in CA
Practice address
215 S Hickory St Ste 112
Escondido, CA 92025-4360
Phone
(760) 737-8460
Fax
(760) 739-5669
NPI assigned
Mar 31, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT298331 CA Primary

Addresses

Primary practice location

215 S Hickory St Ste 112
Escondido, CA 92025-4360

Mailing address

24671 Monroe Ave Ste C102
Murrieta, CA 92562-9589
Phone (951) 200-3620

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200715002719 CA Practitioner - Physical Therapist in Private Practice 4688098296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

1338 Main St
Ramona, CA 92065-2127
Phone (760) 789-1400

215 S Hickory St
Suite 112
Escondido, CA 92025-4360
Phone (760) 737-8460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT298331CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
All Star Physical Therapy Physical Therapist CurrentSince Apr 14, 2020 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

215 S Hickory St
Ste 112
Escondido, CA 92025
Phone (760) 737-8460

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1780212092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24671 MONROE AVE STE C102",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925629589",
            "telephone_number": "951-200-3620",
            "fax_number": "951-200-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S HICKORY ST STE 112",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254360",
            "telephone_number": "760-737-8460",
            "fax_number": "760-739-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "MARK",
        "middle_name": "CHRISTOPHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT298331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.