NPIMap

Individual provider Active NPI

Iris Camille Canicula De Castro, M.D.

  • Nephrology Physician
  • Seattle, WA
National Provider Identifier
1851611875
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD60329901 Issued in WA
Practice address
1959 NE Pacific St
Box 50095
Seattle, WA 98195-0001
Phone
(206) 543-6420
NPI assigned
Jun 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X .60329901 WA
Nephrology Physician 207RN0300X MD60329901 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Box 50095
Seattle, WA 98195-0001

Mailing address

1959 NE Pacific St
Box 50095
Seattle, WA 98195-0001
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
1851611875MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615000202 WA Practitioner - NephrologyPractitioner - Internal Medicine 9032434485 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
.60329901WAMDInternal Medicine Physician
MD60329901WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Washington Current Accepting new patients
University of Washington CurrentSince Sep 1, 2024 Accepting new patients
University of Washington CurrentSince Sep 1, 2024 Accepting new patients
The Association of University Physicians Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients

Locations

4333 Brooklyn Ave NE
Seattle, WA 98195
Phone (206) 221-1700

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

1959 NE Pacific St
#50095
Seattle, WA 98195

Interoperability endpoints

  • Direct secure messaging: idecastro226470@direct.ehre.uwmedicine.org

Organizations & group practices 4

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 4

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": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1851611875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CASTRO",
        "first_name": "IRIS CAMILLE",
        "middle_name": "CANICULA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": ".60329901",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60329901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851611875",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.