Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kendrick Ruelo De Castro, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1235967050

Kendrick Ruelo De Castro, PA-C is a Physician Assistant in Marietta, Georgia. Qualified in 2024, 2 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Marietta, GA

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 1664 Mulkey Rd, Austell, GA 30106-1114 — (770) 422-1372

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12626 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1235967050
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJuly 23, 2024
Last updated in NPPESOctober 21, 2024
Certification dateOctober 21, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Marietta