Mario Eduardo Castellanos

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

42762 Issued in AZ

Practice address

500 W Thomas Rd
Suite 680
Phoenix, AZ 85013-4224

Phone

(602) 406-6017

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1902009251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 56765",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900746765",
            "telephone_number": "602-406-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD",
            "address_2": "SUITE 680",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134224",
            "telephone_number": "602-406-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANOS",
        "first_name": "MARIO",
        "middle_name": "EDUARDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "42762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026446",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "588582",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erik C Castelan, PTA
• Kayla Miricle Castellano
• Aurea Maridia Castellanos, FNP
• Daniel Castellanos, MD
• Jessica Castellanos
• Aliyah Genevie Castelo
• Andrew Casterline, D.D.S.
• Christina L Castillejo, LAC, NCC
• Nadia Castillo Troudart, CRNA
• Alexander John Castillo, BCBA

• Gynecology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Gynecology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.