NPIMap

Organization Active NPI

Starlight Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Hillsboro, IL
National Provider Identifier
1508214446
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
STARLIGHT ANESTHESIA, LLC
Practice address
1200 E Tremont St
Hillsboro, IL 62049-1912
Phone
(618) 960-1185
NPI assigned
Jun 1, 2016
Last updated
Nov 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Authorized official

Name
Kevin James Stein, CRNANPI 1457586455
Title
Member
Phone
(618) 960-1185

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1200 E Tremont St
Hillsboro, IL 62049-1912

Mailing address

116 Starlight Dr
Belleville, IL 62226-4929
Phone (618) 960-1185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221212001361 IL Part B Supplier - Clinic/Group Practice 4082083134 Receives reassigned benefits from 7 practitioners
Practice locations: Hillsboro, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1508214446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 STARLIGHT DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264929",
            "telephone_number": "618-960-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E TREMONT ST",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620491912",
            "telephone_number": "618-960-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "618-960-1185",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.