Individual provider Active NPI

Gregory John Starsiak Jr., DO

  • Family Medicine Physician
  • Thornton, CO
National Provider Identifier
1578025367
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0070915 Issued in CO
Practice address
4075 E 128TH Ave
Thornton, CO 80241-2201
Phone
(303) 925-4210
Fax
(303) 925-4212
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0070915 CO Primary

Addresses

Primary practice location

4075 E 128TH Ave
Thornton, CO 80241-2201

Mailing address

4075 E 128TH Ave
Thornton, CO 80241-2201
Phone (262) 957-6648

Other identifiers 1

IdentifierTypeStateIssuer
0487504MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230525001865 CO Practitioner - Family Practice 5092049262 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

4075 E 128TH Ave
TNNH Primary Care
Thornton, CO 80241-2201
Phone (303) 925-4210

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Family Medicine CurrentSince Jul 10, 2023 Accepting new patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jul 10, 2023 Accepting new patients
Catholic Health Iniatives Colorado Past Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

4075 E 128th Ave
Thornton, CO 80241
Phone (303) 925-4210

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1578025367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 E 128TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412201",
            "telephone_number": "262-957-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 E 128TH AVE",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "802412201",
            "telephone_number": "303-925-4210",
            "fax_number": "303-925-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARSIAK",
        "first_name": "GREGORY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0070915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0487504",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

Verify at the official NPI Registry.