Juvenal Lipana Castillo, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301087182 Issued in MI

Practice address

6172 Chablis LN
Portage, MI 49024-9005

Phone

(917) 816-4427

Fax

(269) 321-0156

NPI assigned

Aug 22, 2006

Last updated

Sep 27, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Visiting Home MD

  dba Physical Medicine and Rehabilitation Specialists of Michigan

  • Physical Medicine & Rehabilitation Physician
  • Portage, MI
  • NPI 1568602050
  Authorized official Same address or phone
• Focus PT Services LLC

  • Physical Therapist
  • Portage, MI
  • NPI 1063736296
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1841306982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6172 CHABLIS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490249005",
            "telephone_number": "917-816-4427",
            "fax_number": "269-321-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6172 CHABLIS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490249005",
            "telephone_number": "917-816-4427",
            "fax_number": "269-321-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTILLO",
        "first_name": "JUVENAL",
        "middle_name": "LIPANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301087182",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036116406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Michael Carrington
• Kari Carrington, BCBA
• Diamond Carter
• Aubrie Case, LLPC
• Bobbi Sue Casey, LMSW
• Elaine Marie Catlin, LMSW
• Margaret Cavanaugh, MA, BCBA, LBA
• Kate Cavataio
• Cbmi2 PLLC
• Gladis Ceballos-Houts, LLPC

• Physical Medicine & Rehabilitation Physician in Portage, MI
• Providers in Portage, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.