NPIMap

Organization Active NPI

Star Orthopedics and Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Coppell, TX
National Provider Identifier
1033939863
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
STAR ORTHOPEDICS AND SPORTS MEDICINE PLLC
Practice address
149 E State Highway 121 Ste 115
Coppell, TX 75019-7985
Phone
(469) 850-0680
Fax
(469) 850-0681
NPI assigned
Oct 16, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrew Peter DoldNPI 1932576980
Title
Owner/MD
Phone
(469) 850-0680

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

149 E State Highway 121 Ste 115
Coppell, TX 75019-7985

Mailing address

5550 Warren Pkwy Ste 230
Frisco, TX 75034-7330
Phone (972) 616-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218000335 TX DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0042571218 Practice locations: Coppell, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Star Ortho Sports Med PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

149 E State Highway 121
Ste 110
Coppell, TX 75019
Phone (469) 850-0680

5550 Warren Pkwy
Ste 200
Frisco, TX 75034
Phone (469) 850-0680

5575 Frisco Square Blvd
Frisco, TX 75034
Phone (972) 234-0200

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1033939863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 WARREN PKWY STE 230",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750347330",
            "telephone_number": "972-616-4000",
            "fax_number": "972-294-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 E STATE HIGHWAY 121 STE 115",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197985",
            "telephone_number": "469-850-0680",
            "fax_number": "469-850-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR ORTHOPEDICS AND SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "DOLD",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "469-850-0680"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coppell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.