Blue Star Rehabilitation, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

BLUE STAR REHABILITATION, LLC

Practice address

800 W Airport Fwy Ste 959
Irving, TX 75062-6312

Phone

(972) 445-4134

Fax

(972) 445-4135

NPI assigned

Apr 21, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Chris Green

Title

Owner

Phone

(214) 796-7205

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela H Grimaldo, NP

  • Family Nurse Practitioner
  • Dallas, TX
  • NPI 1285823344
  Medicare reassignment Care Compare group NPD
• Ravi B Patel, M.D.

  • Internal Medicine Physician
  • Addison, TX
  • NPI 1093764169
  Medicare reassignment Care Compare group NPD
• Margaret Manoti, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Melissa, TX
  • NPI 1730787060
  Medicare reassignment NPD
• Michael Todd Smith, D.C.

  • Chiropractor
  • Irving, TX
  • NPI 1457732232
  NPD (past)
• Katrina M Steele, DC, FNP-C

  • Family Nurse Practitioner
  • Waxahachie, TX
  • NPI 1407891245
  NPD (past)

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569196800000",
    "number": "1588051114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W AIRPORT FWY STE 959",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750626312",
            "telephone_number": "972-445-4134",
            "fax_number": "972-445-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W AIRPORT FWY STE 959",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750626312",
            "telephone_number": "972-445-4134",
            "fax_number": "972-445-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE STAR REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2019-09-23",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-796-7205",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Irving, TX
• Providers in Irving, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.