STAR SURGERY CENTER, LLC
NPI 1235760406
Clinic/Center - Ambulatory Surgical in Peoria, AZ

NPI Status: Active since January 28, 2020

Contact Information

14155 N 83RD AVE STE 140
PEORIA, AZ
ZIP 85381
Phone: (623) 248-5842
Fax: (623) 248-5843

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 03D2177256
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 01-06-2028

About STAR SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Star Surgery Center, Llc, a provider established in Peoria, Arizona operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1235760406 assigned on January 2020. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Star Surgery Center, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Tina Mankin (Administrator)

NPI
1235760406
Provider Name
STAR SURGERY CENTER, LLC
Entity Type
Organization
Location Address
14155 N 83RD AVE STE 140 PEORIA, AZ 85381
Location Phone
(623) 248-5842
Location Fax
(623) 248-5843
Mailing Address
14155 N 83RD AVE STE 140 PEORIA, AZ 85381
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-28-2020
Last Update Date
01-28-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208600000XAllopathic & Osteopathic Physicians

Surgery

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TINA MANKIN

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(602) 510-3203

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Injection of implant material beneath lining of bladder and/or urethra using an endoscope

This is a procedure where a substance is inserted under the bladder or urethra lining using a special instrument called an endoscope. This helps to support these areas and improve their function. It's done in a safe, controlled medical environment.

This service was performed 19 times for 19 patients

Insertion of sacral nerve neurostimulator electrode array

The insertion of a sacral nerve neurostimulator electrode array is a procedure where a small device is placed under your skin. This device sends mild electrical pulses to your sacral nerves, which can help manage certain body functions and alleviate symptoms.

This service was performed 140 times for 70 patients

Plastic repair of muscles at urinary opening through vagina

This is a surgical procedure to fix muscle damage near the body's waste elimination area, accessed via the birth canal. It aids in improving control and prevention of accidental leakage.

This service was performed 14 times for 14 patients

Repair of bladder hernia into vaginal wall

This procedure involves fixing a bulge in the bladder that has extended into the wall of the lower body passage. This bulge may cause discomfort or problems with normal body functions. The process realigns the bladder to its correct position, providing relief.

This service was performed 18 times for 18 patients

Repair of bulging of rectum and bladder into vaginal wall

This procedure involves correcting a condition where the rectum and bladder bulge into the vaginal wall, causing discomfort. The operation helps to restore these organs to their normal position, improving comfort and functionality.

This service was performed 32 times for 32 patients

Repair of pelvic ligaments through vagina

This procedure involves mending the supportive tissues in your lower body region, accessed via the birth canal. It helps enhance stability and alleviate discomfort. The process is performed under anesthesia, ensuring a pain-free experience.

This service was performed 44 times for 44 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D2177256
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
January 07, 2026
Certificate Expiration Date
January 06, 2028
Laboratory Director
M REZA KHARRAZI
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Star Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235760406, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
3
Doubled → 6
Pos 4
5
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 7 → 14 → 5 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 1 + 4 + 6 + 0 + 4 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1235760406.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Anesthesiology
14155 N 83RD AVE STE 140
PEORIA, AZ 85381

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235760406, enumerated as an "organization" on January 28, 2020.

The provider is located at 14155 N 83RD AVE STE 140 PEORIA, AZ 85381 and the phone number is (623) 248-5842.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.