Individual provider Active NPI

Corinna Castillo Peslak, DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
National Provider Identifier
1790304863
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC007103 Issued in PA
Practice address
139 E Lehigh Ave
Philadelphia, PA 19125-1011
Phone
(215) 423-9708
NPI assigned
Apr 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X SC007103 PA
Primary Podiatric Medicine Podiatrist 213EP1101X SC007103 PA
Sports Medicine Podiatrist 213ES0000X SC007103 PA
Foot Surgery Podiatrist 213ES0131X SC007103 PA
Foot & Ankle Surgery Podiatrist 213ES0103X SC007103 PA Primary

Addresses

Primary practice location

139 E Lehigh Ave
Philadelphia, PA 19125-1011

Mailing address

2701 Holme Ave Ste 204
Philadelphia, PA 19152-2029
Phone (215) 335-1914

Other practice location 1

2701 Holme Ave Ste 204
Philadelphia, PA 19152-2029
Phone (215) 335-1914

Other practice location 2

1501 Lansdowne Ave Ste 304
Darby, PA 19023-1333
Phone (610) 623-1599

Other names 1

  • Dr. Corinna Caridad Castillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807000214 PA Practitioner - Podiatry 1052776622 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ali Albert Anaim DPM PCGroup PAC ID 8820060957, 4 clinicians

Practice addresses (Care Compare)

139 E Lehigh Ave
Philadelphia, PA 19125-1011
Phone (215) 423-9708

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.81 of 100Reported as group
Quality
63.62
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue129
Removal of skin lesions1-10
Removal of nail tissue107
Removal or shaving of skin growth28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC007103PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ali Albert Anaim DPM PC Foot & Ankle Surgery CurrentSince Jul 1, 2023 Accepting new patients

Locations

1501 Lansdowne Ave
Ste 304
Darby, PA 19023
Phone (610) 532-8222

2701 Holme Ave
Ste 204
Philadelphia, PA 19152
Phone (215) 333-7293

2601 Holme Ave
Rm 306
Philadelphia, PA 19152

139 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 423-9708

Interoperability endpoints

  • Direct secure messaging: ccastillo2020767@direct.trinity-health.org

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.

Hospital & facility affiliations 9

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1790304863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 HOLME AVE STE 204",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522029",
            "telephone_number": "215-335-1914",
            "fax_number": "215-335-1915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 E LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191251011",
            "telephone_number": "215-423-9708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 Holme Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191522029",
            "country_code": "US",
            "telephone_number": "215-335-1914",
            "fax_number": "215-335-1915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 Lansdowne Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "Darby",
            "state": "PA",
            "postal_code": "190231333",
            "country_code": "US",
            "telephone_number": "610-623-1599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESLAK",
        "first_name": "CORINNA",
        "middle_name": "CASTILLO",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC007103",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC007103",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "PA",
            "license": "SC007103",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC007103",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC007103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORINNA",
            "last_name": "CASTILLO",
            "middle_name": "CARIDAD",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.