Individual provider Active NPI

Mary Ellen Starzinski, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Stuart, FL
National Provider Identifier
1689719411
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
5101008682 Issued in MI
Practice address
5437 SE Schooner Oaks Way
Stuart, FL 34997-2568
Phone
(772) 233-2820
Fax
(772) 233-2820
NPI assigned
Feb 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101008682 MI Primary

Addresses

Primary practice location

5437 SE Schooner Oaks Way
Stuart, FL 34997-2568

Mailing address

5437 SE Schooner Oaks Way
Stuart, FL 34997-2568
Phone (772) 233-2820

Other identifiers 1

IdentifierTypeStateIssuer
0158201724OtherMIBLUE SHIELD

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008682MIMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Osteopathic Center,P.C. Neuromusculoskeletal Medicine & Omm PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689719411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 SE SCHOONER OAKS WAY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349972568",
            "telephone_number": "772-233-2820",
            "fax_number": "772-233-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5437 SE SCHOONER OAKS WAY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349972568",
            "telephone_number": "772-233-2820",
            "fax_number": "772-233-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARZINSKI",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101008682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0158201724",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.