KENDRICK RUELO DE CASTRO PA-C
NPI 1235967050
Physician Assistant in Marietta, GA

Q: What is Kendrick De Castro's NPI number?

The NPI number for Kendrick De Castro is 1235967050. It was assigned to this individual provider in the NPPES registry on July 23, 2024.

Q: What is Kendrick De Castro's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since July 23, 2024PECOS EnrolledAccepts Medicare Assignment

400 TOWER RD NE STE 200, MARIETTA, GA 30060(770) 422-1372 Get Directions Write a Review

NPPES record last updated: October 21, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kendrick Ruelo De Castro Pa-c NPPES

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

KENDRICK RUELO DE CASTRO PA-C (NPI 1235967050) is an individual physician assistant in Marietta, Georgia, licensed in Georgia (12626) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Austell.

NPPES Registry Identity

NPI1235967050

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameKENDRICK RUELO DE CASTROCredential: PA-C

Location Address400 TOWER RD NE STE 200Marietta, GA 30060-9412

Mailing Address1845 Piedmont Ave Ne Apt 522Atlanta, GA 30324-5170 · (404) 861-1549

Phone(770) 422-1372

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 23, 2024

Last NPPES UpdateOctober 21, 2024

NPPES CertifiedOctober 21, 2024

✔ NPI 1235967050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in GA · 12626

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

400 TOWER RD NE STE 200, Marietta, GA 30060

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Secondary Practice Location 1

Location 11664 Mulkey RdAustell, GA 30106-1114 · Phone (770) 422-1372

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kendrick Ruelo De Castro Pa-c 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 ID143754887

PECOS Enrollment IDI20241118000713

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.

Hospital Affiliations CMS Care Compare 3

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

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110143

Location3950 Austell RdAustell, GA 30106 · Cobb County

Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110184

Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30060 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

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

SARIKA MISHRA NP

Nurse Practitioner (Acute Care)