Organization Active NPI

Pediatrics at Cherry Creek,LLC

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1194854406
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32058 Issued in CO
Legal business name
PEDIATRICS AT CHERRY CREEK,LLC
Practice address
300 S Jackson St Ste 300
Denver, CO 80209-3134
Phone
(303) 377-9663
NPI assigned
Mar 4, 2007
Last updated
Jun 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Authorized official

Name
Dr. Elisabeth Staerz, MDNPI 1245325604
Title
Owner
Phone
(303) 377-9663

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32058 CO Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

300 S Jackson St Ste 300
Denver, CO 80209-3134

Mailing address

300 S Jackson St Ste 300
Denver, CO 80209-3134
Phone (303) 377-9663

Other practice location 1

210 University Blvd
Suite 490
Denver, CO 80206-4616
Phone (303) 377-9663

Other identifiers 1

IdentifierTypeStateIssuer
48571555MedicaidCO

Other names 1

  • Pediatrics at Cherry Creek Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D0513024Pediatrics at Cherry Creek LLC300 S Jackson Street, Suite 300, Denver, CO 80209Certificate of waiverDec 15, 2026

National Provider Directory

National Provider Directory
Tax ID family
Pediatrics at Cherry Creekllc2 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

210 University Blvd
Ste 490
Denver, CO 80206
Phone (303) 377-9663

300 S Jackson St
Ste 300
Denver, CO 80209
Phone (303) 377-9663

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1194854406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093134",
            "telephone_number": "303-377-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S JACKSON ST STE 300",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802093134",
            "telephone_number": "303-377-9663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 University Blvd",
            "address_2": "Suite 490",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802064616",
            "country_code": "US",
            "telephone_number": "303-377-9663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PEDIATRICS AT CHERRY CREEK,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-04",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "STAERZ",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-377-9663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "32058",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48571555",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatrics at Cherry Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.