NPIMap

Organization Active NPI

CTMD Medical Center PA

  • Family Medicine Physician
  • Palm Springs, FL
National Provider Identifier
1962066951
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CTMD MEDICAL CENTER PA
Practice address
2328 S Congress Ave # Unite1-H
Palm Springs, FL 33406-7618
Phone
(561) 324-7224
Fax
(561) 225-1780
NPI assigned
Apr 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Luis Castillo, MDNPI 1821233966
Title
Owner
Phone
(561) 324-7224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2328 S Congress Ave # Unite1-H
Palm Springs, FL 33406-7618

Mailing address

2328 S Congress Ave # Unite1-H
Palm Springs, FL 33406-7618
Phone (561) 324-7224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190911000582 FL Part B Supplier - Clinic/Group Practice 3072842400 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Springs, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2189486CTMD Medical Center, PA2328 S Congress Ave Unit 1-H, Palm Springs, FL 33406Certificate of waiverJul 30, 2026

National Provider Directory

National Provider Directory

Locations

2328 S Congress Ave
#1H
Palm Springs, FL 33406
Phone (561) 324-7224

2328 S Congress Ave
Ste 1H
Palm Springs, FL 33406
Phone (561) 324-7224

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1962066951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 S CONGRESS AVE # UNITE1-H",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067618",
            "telephone_number": "561-324-7224",
            "fax_number": "561-225-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 S CONGRESS AVE # UNITE1-H",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334067618",
            "telephone_number": "561-324-7224",
            "fax_number": "561-225-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CTMD MEDICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-324-7224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.