Marlon Decastro, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

C53594 Issued in CA

Practice address

500 Doyle Park Dr
Ste. 303
Santa Rosa, CA 95405-4558

Phone

(707) 303-8300

Fax

(707) 303-8301

NPI assigned

Mar 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence at Home With Compassus Home Health, Sonoma Home health agency, Santa Rosa, CA, CCN 557433
• Accentcare Home Health of California, Inc Home health agency, San Ramon, CA, CCN 057517
• Sutter Care at Home Home health agency, Santa Rosa, CA, CCN 058189
• Gateway Home Health Corp. Home health agency, San Ramon, CA, CCN 053129
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment Care Compare group
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1639715709
  NPD
• Providence Medical Foundation

  • Internal Medicine Physician
  • Santa Rosa, CA
  • NPI 1740584473
  NPD
• Annadel Medical Group, Inc

  • Pediatrics Physician
  • Santa Rosa, CA
  • NPI 1114177425
  NPD (past)
• Anderson Family Care, PA

  • Family Medicine Physician
  • Anderson, SC
  • NPI 1942261185
  NPD (past)

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

• Accentcare Home Health of California, Inc.

  • Home Health Agency
  • San Ramon, CA
  • NPI 1972559961
  Care Compare affiliation
• Gateway Home Health Corp.

  • Home Health Agency
  • San Ramon, CA
  • NPI 1861846693
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation
• St. Joseph Home Care Network

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1801981634
  Care Compare affiliation
• Sutter Visiting Nurse Association and Hospice

  • Home Health Agency
  • Santa Rosa, CA
  • NPI 1205865870
  Care Compare affiliation

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1780643270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "STE 303",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-303-8300",
            "fax_number": "707-303-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR",
            "address_2": "STE. 303",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054558",
            "telephone_number": "707-303-8300",
            "fax_number": "707-303-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECASTRO",
        "first_name": "MARLON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2023-03-07",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "23181",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C53594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA LICENSE",
            "identifier": "C53594",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "23181",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHEC",
            "identifier": "20-23181",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231813",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdecastro1657619@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1162 Montgomery Dr",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954054802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lester I. Debbold, MD
• Wendell Paul Debele, L . AC
• Molly K Debrock, MA
• Christina Debrunner
• Sydney Joye Decastilhos, FNP, BC
• Veronica Decicco, PH.D.
• Emily Decker, RN, PHN
• Suzanne Watts Dedmore, RN, FNP-C
• Ramzi Khalil Deeik, M.D.
• L. Stanley Deen, MD

• Internal Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.