Individual provider Active NPI

Sebastian Thomas Castelli, D.C.

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1831295187
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 8785 Issued in FL
Practice address
12187 Beach Blvd Ste 1
Jacksonville, FL 32246-0620
Phone
(904) 854-9353
Fax
(904) 212-2727
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 8785 FL Primary

Addresses

Primary practice location

12187 Beach Blvd Ste 1
Jacksonville, FL 32246-0620

Mailing address

12187 Beach Blvd Ste 1
Jacksonville, FL 32246-0620
Phone (904) 854-9353

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050615000287 FL Practitioner - Chiropractic 7618911157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Castelli Chiropractic Center, LLCGroup PAC ID 2860718368, 2 clinicians

Practice addresses (Care Compare)

12187 Beach Blvd
Suite 1
Jacksonville, FL 32246-0620
Phone (904) 854-9353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 8785FLMDChiropractor

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1831295187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12187 BEACH BLVD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460620",
            "telephone_number": "904-854-9353",
            "fax_number": "904-212-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12187 BEACH BLVD STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460620",
            "telephone_number": "904-854-9353",
            "fax_number": "904-212-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLI",
        "first_name": "SEBASTIAN",
        "middle_name": "THOMAS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 8785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.