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STAR REHAB PROF PHYSICIANS LLC NPI 1922000421


NPI Information

NPI: 1922000421
Provider Name: STAR REHAB PROF PHYSICIANS, LLC

Doing Business As: STAR REHAB, LLC

Classification: Physical Medicine & Rehabilitation - 2081P2900X
Entity Type: Organization

Specialization: Pain Medicine

Address:
201 S MCCULLOCH BLVD
PUEBLO WEST, CO
ZIP 81007
Phone: (719) 561-5377
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STAR REHAB PROF PHYSICIANS, LLC is a pain medicine physical medicine rehabilitation in Pueblo West, CO. The provider is a physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. STAR REHAB PROF PHYSICIANS, LLC NPI is 1922000421. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Star Rehab, Llc.

The provider's business location address is:

201 S MCCULLOCH BLVD
PUEBLO WEST, CO
ZIP 81007-892
Phone: (719) 561-5377

The provider's authorized official is Lynda Mariko Tsuha .
The authorized official title is Coo and has the following contact phone number (719) 561-5377.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 8/6/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine44011COLORADONo
2208100000XPhysical Medicine & Rehabilitation31344KANSASNo
32081P2900XPhysical Medicine & RehabilitationPain Medicine04-31652KANSASNo
42081P2900XPhysical Medicine & RehabilitationPain Medicine39112COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C803160MEDICARE PINCOLORADO
2DE2582OTHERCOLORADORR MEDICARE
3111176MEDICARE PINKANSAS
4DE2582OTHERKANSASRR MEDICARE
5200362680AMEDICAIDKANSAS
653283589MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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