NPIMap

Individual provider Active NPI

Justin William Starling

  • Surgical Physician Assistant
  • Springfield, IL
National Provider Identifier
1629592225
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1515 Keys Ave
Springfield, IL 62702-2933
Phone
(217) 816-1606
NPI assigned
Jul 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1515 Keys Ave
Springfield, IL 62702-2933

Mailing address

1515 Keys Ave
Springfield, IL 62702-2933
Phone (217) 816-1606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025002855 NV Practitioner - Physician Assistant 9436425071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Southern College of Medicine and Surgery, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Regional Spine InstituteGroup PAC ID 0244210409, 3 clinicians

Practice addresses (Care Compare)

6630 S McCarran Blvd
Suite A4
Reno, NV 89509-6145
Phone (775) 828-2873

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services - Reno LLC Past Accepting new patients

Organizations & group practices 3

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 5

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": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1629592225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 KEYS AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022933",
            "telephone_number": "217-816-1606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 KEYS AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627022933",
            "telephone_number": "217-816-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARLING",
        "first_name": "JUSTIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-26",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.