Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Shasta Victoria Grimes Castro-Penullar, BSPT

Individual provider Physical Therapist · NPI 1699819730

Mrs. Shasta Victoria Grimes Castro-Penullar, BSPT is a Physical Therapist in Private Practice in Jersey City, New Jersey. Qualified in 1997, 29 years ago. Practices with New Jersey Spine and Pain Institute , LLC, a 5-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
29
Licensed in
NJ
In the registry since
2007
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Practice location Address checks out

242 10th St
Jersey City, NJ 07302-1406
Phone: (201) 795-2499
Fax: (201) 795-3579
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (NJ)

Record details

NPI number1699819730
Entity typeIndividual (Type 1)
GenderFemale
Credentials BSPT
Sole proprietorYes
NPI enumeratedFebruary 19, 2007
Last updated in NPPESDecember 10, 2007

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice New Jersey Spine And Pain Institute ,Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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