Individual provider Active NPI

Anatoly Starosta

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1205896040
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
018716 Issued in NY
Practice address
1704 Mermaid Ave
Brooklyn, NY 11224-2622
Phone
(718) 265-0900
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 018716 NY Primary

Addresses

Primary practice location

1704 Mermaid Ave
Brooklyn, NY 11224-2622

Mailing address

1704 Mermaid Ave
Brooklyn, NY 11224-2622
Phone (718) 265-0900

Other identifiers 1

IdentifierTypeStateIssuer
02193199MedicaidNY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mermaid Operating Co, LLC Physical Therapist PastSince Nov 4, 2005 Accepting new patients
A Merryland Operating LLC Past Accepting new patients
University Physicians Group P C Past Accepting new patients
University Physicians Group Endocrinology PLLC Past Accepting new patients

Organizations & group practices 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1205896040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242622",
            "telephone_number": "718-265-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 MERMAID AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112242622",
            "telephone_number": "718-265-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAROSTA",
        "first_name": "ANATOLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "018716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02193199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; 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.