Individual provider Active NPI

Craig Michael Decastro, DDS

  • General Practice Dentistry
  • Oneida, NY
National Provider Identifier
1902983455
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
053154-1 Issued in NY
Practice address
308 Main St
Oneida, NY 13421-2125
Phone
(315) 363-4850
Fax
(315) 363-4678
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 053154-1 NY Primary

Addresses

Primary practice location

308 Main St
Oneida, NY 13421-2125

Mailing address

308 Main St
Oneida, NY 13421-2125
Phone (315) 363-4850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161018002299 NY Order and Referring Only - DentistPractitioner - Dentist 1052609443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053154NYMDClinical Social Worker
053154-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oneida Dental Practice PC General Practice PastSince Jan 1, 2011 Accepting new patients

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902983455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 MAIN ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212125",
            "telephone_number": "315-363-4850",
            "fax_number": "315-363-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 MAIN ST",
            "city": "ONEIDA",
            "state": "NY",
            "postal_code": "134212125",
            "telephone_number": "315-363-4850",
            "fax_number": "315-363-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECASTRO",
        "first_name": "CRAIG",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "053154-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oneida, NY

Sources for this page

Verify at the official NPI Registry.