Individual provider Active NPI

Michael Castro, O.D.

  • Optometrist
  • Schertz, TX
National Provider Identifier
1841675360
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8683TG Issued in TX
Practice address
17460 Interstate 35 N Ste 412
Schertz, TX 78154-1222
Phone
(210) 590-2482
Fax
(210) 579-9490
NPI assigned
Jul 26, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8683T TX
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8683TG TX Primary

Addresses

Primary practice location

17460 Interstate 35 N Ste 412
Schertz, TX 78154-1222

Mailing address

17460 Interstate 35 N Ste 412
Schertz, TX 78154-1222
Phone (210) 590-2482

Other practice location 1

17460 Interstate 35 N Ste 412
Schertz, TX 78154-1222
Phone (210) 590-2482

Other identifiers 2

IdentifierTypeStateIssuer
1770870883OtherTXGROUP NPI
1841675360OtherTXINDIVIDUAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20151002000333 TX Practitioner - Optometry 2466760947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17460 Ih 35
Suite 412
Schertz, TX 78154-1222
Phone (210) 590-2482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8683TTXMDOptometrist
8683TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nielsen Vision Development Center Single Specialty PastSince Feb 26, 2019 Accepting new patients
Nielsen Vision Development Center, LLC Single Specialty PastSince Sep 5, 2021 Accepting new patients

Organizations & group practices 3

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": "1437868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1841675360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17460 INTERSTATE 35 N STE 412",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781541222",
            "telephone_number": "210-590-2482",
            "fax_number": "210-579-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17460 INTERSTATE 35 N STE 412",
            "city": "SCHERTZ",
            "state": "TX",
            "postal_code": "781541222",
            "telephone_number": "210-590-2482",
            "fax_number": "210-579-9490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17460 Interstate 35 N Ste 412",
            "address_purpose": "LOCATION",
            "city": "Schertz",
            "state": "TX",
            "postal_code": "781541222",
            "country_code": "US",
            "telephone_number": "210-590-2482",
            "fax_number": "210-579-9490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-26",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8683T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8683TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1770870883",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1841675360",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schertz, TX

Sources for this page

Verify at the official NPI Registry.