Star Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

STAR SURGERY CENTER, LLC

Practice address

14155 N 83Rd Ave Ste 140
Peoria, AZ 85381-5652

Phone

(623) 248-5842

Fax

(623) 248-5843

NPI assigned

Jan 28, 2020

Last updated

Jan 28, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tina Mankin

Title

Administrator

Phone

(602) 510-3203

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Star Surgery Center LLCCCN 03C0001454

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Ali Azadi, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Peoria, AZ
  • NPI 1881810224
  NPD
• Taraneh Yeganeh

  • Pharmacist
  • Louisville, KY
  • NPI 1528571734
  NPD
• Mohamad Reza Kharrazi, MD

  • Anesthesiology Physician
  • Scottsdale, AZ
  • NPI 1336139237
  NPD (past)

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1235760406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE STE 140",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14155 N 83RD AVE STE 140",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815652",
            "telephone_number": "623-248-5842",
            "fax_number": "623-248-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "MANKIN",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-510-3203"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danika Marlynn Stampfel, M.S., CCC-SLP
• Stand-Up MRI of Arizona, LLC
• Trena Melee Stansberry, RN
• Samantha Grace Stapleton, SLP
• Star Clinic LLC
• Starlight Wellness LLC
• Susan Lynn Stefanski, FNP
• Whitney Anne Stefanski, M.S. CCC-SLP
• Elizabeth Amy Steffens, NP
• Shawna Steffes, PMHNP

• Ambulatory Surgical Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.