SERTOMA STAR SERVICES, INC.
NPI 1629830815
Clinic/Center - Mental Health (Including Community Mental Health Center) in Matteson, IL
About Sertoma Star Services, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SERTOMA STAR SERVICES, INC. (NPI 1629830815) is a healthcare organization registered as a mental health (including community mental health center) in Matteson, Illinois and active in the NPI registry since January 2024. The organization lists Gus Van Den Brink, President/ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sertoma Star Services, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Sertoma Star Services, Inc., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sertoma Star Services, Inc.'s NPI number?
The NPI number for Sertoma Star Services, Inc. is 1629830815. It was assigned to this organization in the NPPES registry on January 24, 2024.
Where is Sertoma Star Services, Inc. located?
Sertoma Star Services, Inc. is located at 4331 Lincoln Hwy, Matteson, IL 60443. The listed phone number is (708) 755-8030.
What is Sertoma Star Services, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Sertoma Star Services, Inc. enrolled in Medicare?
Yes. Sertoma Star Services, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sertoma Star Services, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Sertoma Star Services, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Sertoma Star Services, Inc. was last updated on February 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sertoma Star Services, Inc. · NPI 1629830815
Mental Health (Including Community Mental Health Center) organization in Matteson, Illinois. Organization record, active in the CMS NPPES registry since January 24, 2024.
## Identity
- **NPI:** 1629830815 (Entity type: Organization)
- **Enumerated:** January 24, 2024
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Gus Van Den Brink, PRESIDENT/CEO
## Practice location
- **Address:** 4331 LINCOLN HWY, Matteson, IL 60443-2404
- **Phone:** (708) 755-8030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 5, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1629830815) · Data from the CMS NPPES public registry.