MR. JODY JAMES DECASTRO


Address: 1910 Sassafras St Ste 300, Erie, PA 16502-2716
Phone: 8144527575

MR. JODY JAMES DECASTRO (NPI# 1457633943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457633943
Entity Type Individual
Full Name MR. JODY JAMES DECASTRO
Credential PA-C
Practice Address 1910 Sassafras St Ste 300
Erie
PA 16502-2716
Practice Telephone 8144527575
Practice Fax Number 8144527574
Mailing Telephone 8144527575
Mailing Fax Number 8144527574
Enumeration Date 2011-09-12
Last Update Date 2019-02-06
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
MA055017 PA Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
015034 NY Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CAQH 12292814 01

Office Location

Street Address 1910 SASSAFRAS ST STE 300
City ERIE
State PA
Zip Code 16502-2716

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417994682 Rodney S. Bingham Anesthesiology 1910 Sassafras St Ste 300, Erie, PA 16502-2716 2006-05-31
1528497948 Derrick Andrew Dupre Neurological Surgery 1910 Sassafras St Ste 300, Erie, PA 16502 2013-11-06
1104267830 Feno M Monaco Anesthesiology 1910 Sassafras St Ste 300, Erie, PA 16502-2716 2013-07-10
1255691820 Theodore Gary Eckman Anesthesiology 1910 Sassafras St Ste 300, Erie, PA 16502-2716 2012-05-17
1760761654 Matthew A Depaul Nurse Practitioner 1910 Sassafras St Ste 300, Erie, PA 16502-2716 2011-08-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679064794 Fernando Torres Specialist/Technologist 549 1/2 W 7th St, Erie, PA 16502 2018-05-24
1548782907 Michael Wayne Hankins Jr. Podiatrist 5515 Peach Street, Erie, PA 16502 2017-07-07
1730609041 Michael Greg Palmer Family Medicine 311 West 24th Street 4th Floor, Erie, PA 16502 2017-06-27
1245658723 Amy Adamus Licensed Practical Nurse 1647 Sassafras Street, Erie, PA 16502 2014-04-02
1295011088 Margaret Gay Wardd Licensed Practical Nurse 1757 West 23 Street, Erie, PA 16502 2011-10-25
1659510782 Kristen Kathleen Curry Social Worker 329 W. 10th St., Erie, PA 16502 2009-02-12
1699928416 Kelly Cathleen Kelly-zazado Social Worker 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 2008-10-23
1922149350 Wei-lung Sam Wu Internal Medicine Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 2007-02-09
1003970146 Claire Donch Psychologist 301 West 10th Street, Erie, PA 16502 2006-12-21
1730703117 Vincent Viet Ngo Family Medicine 311 West 24th Street, 4th Floor, Erie, PA 16502 2020-06-02
Find all providers in zip 16502

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1306496872 Maureen Grady Physician Assistant 240 West 11th Street, Suite 2, Erie, PA 16501 2019-09-17
1174920193 Shelly A. Respecki Physician Assistant 120 E Second St 3rd Floor, Erie, PA 16507-1578 2014-11-20
1801105127 Diane Marie Corey Physician Assistant 2620 Sigsbee St, Erie, PA 16508-1721 2010-10-04
1124124318 Tamara J. Murphy Physician Assistant 100 Peach Street, Suite 200, Bayfront Digestive Disease, Erie, PA 16507-1423 2006-09-15
1508472622 Liam Cunningham Physician Assistant 2374 Village Common Dr Ste 100, Erie, PA 16506-7201 2020-09-23
1679181093 Micaela M Lippert Physician Assistant 333 State St Ste 104, Erie, PA 16507-1463 2020-07-22
1255971222 Emina Vakufac Physician Assistant 2202 W 15th St, Erie, PA 16505-4510 2020-01-08
1679118269 Alexandra Marie Hartman Physician Assistant 232 W 25th St, Erie, PA 16544-0002 2019-11-07
1982254173 Erin Elizabeth Lipnicky Physician Assistant 118 E 2nd St, Erie, PA 16507-1502 2019-09-19
1841756483 Justine M Koehler Physician Assistant 2315 Myrtle St Ste 190, Erie, PA 16502-4604 2019-02-19
Find all providers in ERIE

Competitor

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City ERIE
Zip Code 16502

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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