DR. JUSTINE DE LA ROSA DECASTRO M.D.
NPI 1194936831
Family Medicine in Mount Pleasant, SC

Active since May 24, 2007PECOS EnrolledAccepts Medicare Assignment
246 MATHIS FERRY RD STE 100, MOUNT PLEASANT, SC 29464(843) 900-6742 Get Directions Write a Review

NPPES record last updated: April 23, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 23, 2026, Jan 23, 2026, Jul 3, 2023 (3 updates tracked since 2023).

About Dr. Justine De La Rosa Decastro M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JUSTINE DE LA ROSA DECASTRO M.D. (NPI 1194936831) is an individual family medicine provider in Mount Pleasant, South Carolina, licensed in South Carolina (32980) and active in the NPI registry since May 2007. She is enrolled in Medicare PECOS, is affiliated with Tidelands Georgetown Memorial Hospital, and is a graduate of University Of South Carolina School Of Medicine (2006).

NPPES Registry Identity

NPI1194936831
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JUSTINE DE LA ROSA DECASTROCredential: M.D.
Location Address246 MATHIS FERRY RD STE 100Mount Pleasant, SC 29464-2987
Mailing Address1050 Johnnie Dodds Blvd # 1116Mount Pleasant, SC 29464-3684
Sole ProprietorNo
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2006
Enumeration DateMay 24, 2007
Last NPPES UpdateApril 23, 20263 updates tracked since enumeration
NPPES CertifiedApril 23, 2026
✔ NPI 1194936831 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in SC · 32980
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
246 MATHIS FERRY RD STE 100, Mount Pleasant, SC 29464

Other Identifiers 2

Medicaid329807SC
OtherP01214786SC · Rr-medicare

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Justine De La Rosa Decastro M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537308242
PECOS Enrollment IDI20130726000539
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Justine Decastro reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Internal Medicine
2375 BAKER HOSPITAL BLVD
North Charleston, SC 29405
  • Reassigned Medicare billing, South Carolina enrollment
  • 409 clinicians in this Medicare group
Geriatric Medicine
27 GAMECOCK AVE, STE 201
Charleston, SC 29407
  • Reassigned Medicare billing, South Carolina enrollment
  • 26 clinicians in this Medicare group
Family
6650 RIVERS AVE
North Charleston, SC 29406
  • Reassigned Medicare billing, South Carolina enrollment
  • 338 clinicians in this Medicare group
Urgent Care
515 SAINT JAMES AVE
Goose Creek, SC 29445
  • Reassigned Medicare billing, South Carolina enrollment
  • 55 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
402 services186 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
188 services110 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
119 services109 patients
Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
52 services44 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
48 services38 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
42 services42 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tidelands Georgetown Memorial Hospital

Acute Care Hospitals · Georgetown, SC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number420020
Location606 Black River Rd Drawer 1718Georgetown, SC 29440 · Georgetown County
Emergency services

East Cooper Medical Center

Acute Care Hospitals · Mount Pleasant, SC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number420089
Location2000 Hospital DrMount Pleasant, SC 29464 · Charleston County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29464 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
66%269 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
62%422 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
41%87 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
87%4,612 patients3/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
56%1,335 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%562 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
69%1,454 patients3/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
96%1,454 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
65%1,454 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
67%1,454 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
246 MATHIS FERRY RD STE 100
MOUNT PLEASANT, SC 29464
Family Medicine
246 MATHIS FERRY RD STE 100
MT PLEASANT, SC 29464
Family Medicine
246 MATHIS FERRY RD STE 100
MOUNT PLEASANT, SC 29464

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justine Decastro's NPI number?

The NPI number for Justine Decastro is 1194936831. It was assigned to this individual provider in the NPPES registry on May 24, 2007.

Where is Justine Decastro located?

Justine Decastro practices at 246 Mathis Ferry Rd Ste 100, Mount Pleasant, SC 29464. The listed phone number is (843) 900-6742.

What is Justine Decastro's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Justine Decastro enrolled in Medicare?

Yes. Justine Decastro is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Justine Decastro's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Justine Decastro reassigns Medicare benefits to 4 organizations: Curana Health Of South Carolina PC (North Charleston, SC), John E. Emmel, MD, PC (Charleston, SC), Ch Specialty Services Sc LLC (North Charleston, SC) and Charleston Carenow Urgent Care, LLC (Goose Creek, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justine Decastro's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Justine Decastro accept?

Health plans from First Choice Next list Justine Decastro as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Justine Decastro affiliated with any hospitals?

According to CMS data, Justine Decastro is affiliated with Tidelands Georgetown Memorial Hospital and East Cooper Medical Center.

When was this NPI record last updated?

The NPPES record for Justine Decastro was last updated on April 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.