Individual provider Active NPI

Rudolfo Castillo Deleon Jr., FNP

  • Family Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1881821692
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP117969 Issued in TX
Practice address
14254 S Padre Island Dr Ste 207
Corpus Christi, TX 78418-6278
Phone
(361) 537-3605
Fax
(361) 589-4079
NPI assigned
Jun 18, 2009
Last updated
Jul 13, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 677578 TX
Family Nurse Practitioner 363LF0000X 677578 TX
Family Nurse Practitioner 363LF0000X AP117969 TX Primary

Addresses

Primary practice location

14254 S Padre Island Dr Ste 207
Corpus Christi, TX 78418-6278

Mailing address

PO Box 61160
Corpus Christi, TX 78466-1160
Phone (361) 589-4068

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090904000090 TX Practitioner - Nurse Practitioner 3274688726 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
677578TXMDNurse Practitioner
AP117969TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Access Total Care, LLC CurrentSince Dec 17, 2017 Accepting new patients
Ghep Corpus Christi PLLC Past Accepting new patients
Abk Emergency Physicians PLLC Nurse Practitioner Past Accepting new patients

Locations

14254 Spid Dr
Ste 207
Corpus Christi, TX 78418
Phone (361) 537-3605

401 E King Ave
Kingsville, TX 78363
Phone (361) 221-2943

1700 Wildcat Dr
Ste B
Portland, TX 78374
Phone (361) 704-6368

Organizations & group practices 5

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1881821692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61160",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784661160",
            "telephone_number": "361-589-4068",
            "fax_number": "361-589-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14254 S PADRE ISLAND DR STE 207",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186278",
            "telephone_number": "361-537-3605",
            "fax_number": "361-589-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON",
        "first_name": "RUDOLFO",
        "middle_name": "CASTILLO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-18",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "677578",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "677578",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP117969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.