Individual provider Active NPI

Veronica Castro, PA-C

  • Physician Assistant
  • East Northport, NY
National Provider Identifier
1821694449
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
025578-01 Issued in NY
Practice address
558 Larkfield Rd
East Northport, NY 11731-4204
Phone
(631) 486-7459
NPI assigned
Dec 9, 2020
Last updated
Mar 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 025578-01 NY Primary

Addresses

Primary practice location

558 Larkfield Rd
East Northport, NY 11731-4204

Mailing address

212 Vernon Valley Rd
East Northport, NY 11731-1155
Phone (914) 320-3997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210423002179 NY Practitioner - Physician Assistant 0244648640 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Urgent Care of Nesconset PLLCGroup PAC ID 5092985986, 17 clinicians
Excel Urgent Care of East Northport PLLCGroup PAC ID 5294909826, 19 clinicians

Practice addresses (Care Compare)

465 Smithtown Blvd
Nesconset, NY 11767-2421
Phone (631) 676-6700

558 Larkfield Rd
East Northport, NY 11731-4204
Phone (631) 486-7459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
025578NYMDPhysical Therapist
025578-01NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 30, 2022 Accepting new patients
Good Samaritan Hospital Medical CurrentSince May 1, 2021 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1821694449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 VERNON VALLEY RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117311155",
            "telephone_number": "914-320-3997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 LARKFIELD RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314204",
            "telephone_number": "631-486-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "VERONICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "025578-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

Verify at the official NPI Registry.