Physician Compare National (NPI:1194043034)

HEALTHCARE PROVIDER: DEXTER RUNA CASTA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1194043034
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365566205
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140609001817
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CASTA
	Individual professional last name
Provider First Name	DEXTER
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2003
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CARRIS HEALTH LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7012274228
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	173
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	101 WILLMAR AVE SW
	Group Practice or individual's line 1 address
City	WILLMAR
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	562013556
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3202354543
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	241366
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEEKER MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	240088
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CARRIS HEALTH LLC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	240036
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST CLOUD HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	241365
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SWIFT COUNTY BENSON HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y