Individual provider Active NPI

Richard W Starrett, MD

  • Vascular Surgery Physician
  • San Jose, CA
National Provider Identifier
1104847656
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
G22010 Issued in CA
Practice address
2512 Samaritan CT Ste E
San Jose, CA 95124-4002
Phone
(408) 358-8272
Fax
(408) 356-7779
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X G22010 CA Primary

Addresses

Primary practice location

2512 Samaritan CT Ste E
San Jose, CA 95124-4002

Mailing address

2512 Samaritan CT Ste E
San Jose, CA 95124-4002
Phone (408) 358-8272

Other identifiers 2

IdentifierTypeStateIssuer
756021161OtherCARAILROAD MEDICARE PIN
00G220100MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC Past Accepting new patients
Vascular Associates of Northern California Vascular Surgery Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1104847656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 SAMARITAN CT STE E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244002",
            "telephone_number": "408-358-8272",
            "fax_number": "408-356-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 SAMARITAN CT STE E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244002",
            "telephone_number": "408-358-8272",
            "fax_number": "408-356-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARRETT",
        "first_name": "RICHARD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "G22010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "756021161",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G220100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.