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TIMOTHY DUANE STARNER MD
NPI 1972592004
Pediatrics - Pediatric Pulmonology in Madison, WI

Active since October 20, 2005PECOS Enrolled
77.43/100
CMS Quality Rating
5522 DAHLEN DR, MADISON, WI 53705(319) 621-6170 Get Directions Write a Review

NPPES record last updated: October 16, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 16, 2023, Dec 8, 2021, Jan 13, 2021 and 2 more (5 updates tracked since 2019).

About Timothy Duane Starner Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY DUANE STARNER MD (NPI 1972592004) is an individual pediatric pulmonology provider in Madison, Wisconsin, licensed in Wisconsin (70625-20) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1972592004
Entity TypeIndividualMale
Primary Taxonomy2080P0214X
Provider Legal NameTIMOTHY DUANE STARNERCredential: MD
Location Address5522 DAHLEN DRMadison, WI 53705-1342
Mailing Address5522 Dahlen DrMadison, WI 53705-1342 · (319) 621-6170
Phone(319) 621-6170
Sole ProprietorNo
Enumeration DateOctober 20, 2005
Last NPPES UpdateOctober 16, 20235 updates tracked since enumeration
NPPES CertifiedOctober 16, 2023
✔ NPI 1972592004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric PulmonologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0214X
Licenses✔ Licensed in WI · 70625-20✔ Licensed in IA · 32733
Definition
A pediatrician dedicated to the prevention and treatment of all respiratory diseases affecting infants, children and young adults. This specialist is knowledgeable about the growth and development of the lung, assessment of respiratory function in infants and children, and experienced in a variety of invasive and noninvasive diagnostic techniques.
5522 DAHLEN DR, Madison, WI 53705
Open in Google Maps ↗

Other Identifiers 3

Medicaid34503500WI
Other40226IA · Wellmark Bcbs
Medicaid0235820IA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Timothy Duane Starner Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Timothy Starner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carle Health Medical Group
215 mi
Internal Medicine
611 W PARK ST
Urbana, IL 61801
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Carle Health Care Incorporated
  • 2,516 clinicians in this Medicare group
NPI 1154653947 (217) 383-8300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.83
Promoting Interoperability77
Improvement Activities40
Cost62.12

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 Timothy Starner's NPI number?

The NPI number for Timothy Starner is 1972592004. It was assigned to this individual provider in the NPPES registry on October 20, 2005.

Where is Timothy Starner located?

Timothy Starner practices at 5522 Dahlen Dr, Madison, WI 53705. The listed phone number is (319) 621-6170.

What is Timothy Starner's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Pulmonology, with taxonomy code 2080P0214X.

Is Timothy Starner enrolled in Medicare?

Yes. Timothy Starner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Timothy Starner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Starner reassigns Medicare benefits to Carle Health Medical Group (Urbana, IL). The 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 Timothy Starner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Timothy Starner was last updated on October 16, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.