LYAH ALEXANDRA CASTLEBERRY
NPI 1477300978
Physician Assistant - Medical in Placerville, CA

Active since May 02, 2024PECOS Enrolled
4212 MISSOURI FLAT RD, PLACERVILLE, CA 95667(530) 621-7700 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2025, May 2, 2024 (2 updates tracked since 2024).

About Lyah Alexandra Castleberry NPPES

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

LYAH ALEXANDRA CASTLEBERRY (NPI 1477300978) is an individual medical provider in Placerville, California, licensed in California (PA65324) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477300978
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLYAH ALEXANDRA CASTLEBERRY
Location Address4212 MISSOURI FLAT RDPlacerville, CA 95667-6269
Mailing Address4212 Missouri Flat RdPlacerville, CA 95667-6269 · (530) 621-7700
Sole ProprietorNo
Enumeration DateMay 2, 2024
Last NPPES UpdateMarch 17, 20252 updates tracked since enumeration
NPPES CertifiedMarch 17, 2025
NPI 1477300978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · PA65324
4212 MISSOURI FLAT RD, Placerville, CA 95667

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Lyah Alexandra Castleberry is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Nurse Practitioner
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Nurse Practitioner (Family)
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Dentist (General Practice)
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Optometrist
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Clinic/Center (Primary Care)
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Family Medicine
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Dentist (General Practice)
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667
Registered Nurse
4212 MISSOURI FLAT RD
PLACERVILLE, CA 95667

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 Lyah Castleberry's NPI number?

The NPI number for Lyah Castleberry is 1477300978. It was assigned to this individual provider in the NPPES registry on May 2, 2024.

Where is Lyah Castleberry located?

Lyah Castleberry practices at 4212 Missouri Flat Rd, Placerville, CA 95667. The listed phone number is (530) 621-7700.

What is Lyah Castleberry's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Lyah Castleberry enrolled in Medicare?

Yes. Lyah Castleberry is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lyah Castleberry was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.