Individual provider Active NPI

Elisabeth Staerz, MD

  • Pediatrics Physician
  • Denver, CO
National Provider Identifier
1245325604
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32058 Issued in CO
Practice address
300 S Jackson St Ste 300
Denver, CO 80209
Phone
(303) 377-9663
Fax
(303) 377-9954
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32058 CO Primary

Addresses

Primary practice location

300 S Jackson St Ste 300
Denver, CO 80209

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
01320589MedicaidCO

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32058COMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics at Cherry Creek,LLC Pediatrics CurrentSince Jun 15, 2021 Accepting new patients
Pediatrics at Cherry Creek,LLC Pediatrics CurrentSince Jul 25, 2019 Accepting new patients

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1245325604",
    "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",
            "fax_number": "303-377-9954"
        },
        {
            "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": "80209",
            "telephone_number": "303-377-9663",
            "fax_number": "303-377-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAERZ",
        "first_name": "ELISABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "32058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01320589",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 14, 2021; 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.