STAR STATE HEART PLLC (NPI# 1477884740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477884740 |
| Entity Type | Organization |
| Organization Name | STAR STATE HEART PLLC |
| Other Organization Name | STAR STATE HEART & VASCULAR PLLC |
| Practice Address |
200 Medical Pkwy Suite 270 Lakeway TX 78738-1782 |
| Mailing Address |
Po Box Pox # 731393 Dallas TX 75373-1393 |
| Practice Telephone | 5122630123 |
| Practice Fax Number | 5123675841 |
| Mailing Telephone | 5122630123 |
| Mailing Fax Number | 5123675841 |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2012-11-08 |
| Authorized Official Name | DR. SAMUEL J. DEMAIO (OWNER) |
| Authorized Official Telephone | 5122630123 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
G6655 | TX | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G6655 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICAID | 134703111 | 01 |
| TX | MEDICAID | 211911702 | 01 |
| TX | MEDICARE | TXB144747 | 01 |
| TX | MEDICARE | 8F24108 | 01 |
| TX | MEDICARE | TXB144746 | 01 |
| Other Name | Type Code |
|---|---|
| Star State Heart & Vascular PLLC | Doing Business As Name - Organization |
| Street Address |
200 MEDICAL PKWY SUITE 270 |
| City | LAKEWAY |
| State | TX |
| Zip Code | 78738-1782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530826 | Kevin Lee Hoffarth | Family Medicine | 200 Medical Pkwy, Suite 310, Lakeway, TX 78738-1782 | 2005-06-28 |
| 1679020986 | U S Anesthesia Partners of Texas | Anesthesiology | 200 Medical Pkwy, Suite 380, Lakeway, TX 78738-1791 | 2016-09-02 |
| 1619355724 | Lrmc Neurosurgery, Inc. | Neurological Surgery | 200 Medical Pkwy, Suite 310, Lakeway, TX 78738-1791 | 2015-05-08 |
| 1467799601 | Sleep Apnea Associates of Texas, Pllc | Dentist | 200 Medical Pkwy, Suite 270, Lakeway, TX 78738-1782 | 2013-01-08 |
| 1669718672 | Lrmc Orthopedics, Inc. | Orthopaedic Surgery | 200 Medical Pkwy, Suite 130, Lakeway, TX 78738-1782 | 2012-12-19 |
| 1679831077 | Matthew Blake Freeman | Psychiatry & Neurology | 200 Medical Pkwy, Lakeway, TX 78738-1792 | 2012-04-24 |
| 1689948879 | Brett E Smith | Podiatrist | 200 Medical Pkwy, Ste 130, Lakeway, TX 78738 | 2012-03-06 |
| 1548390909 | Naresh Venkat Desireddi | Urology | 200 Medical Pkwy, #350, Lakeway, TX 78738-1791 | 2007-03-06 |
| 1437232170 | Katherine A. Gilliland | Nurse Practitioner | 200 Medical Pkwy, Lakeway, TX 78738-1791 | 2006-10-24 |
| 1295796431 | Russell David Calvo Jr. | Orthopaedic Surgery | 200 Medical Pkwy, 130, Lakeway, TX 78738-1791 | 2006-03-29 |
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| 1447807839 | Texas Physical Therapy Specialists | Durable Medical Equipment & Medical Supplies | 101 Medical Parkway, Suite 110, Lakeway, TX 78738 | 2019-08-21 |
| 1831744101 | Laurel Brynne Boyd | Physical Therapist | 2501 Rr 620, Suite 140, Lakeway, TX 78738 | 2019-08-05 |
| 1033777404 | Maria Wesley-pinion Lcsw Csat Pllc | Social Worker | 2802 Flintorock Trace, Suite B101, Lakeway, TX 78738 | 2019-05-31 |
| 1801362637 | Iq Dental Pllc | Dentist | 15511 State Highway 71 West, Suite # 120, Bee Cave, TX 78738 | 2018-10-19 |
| 1790264687 | Doctx3 Pllc | Orthopaedic Surgery | 11514 Bee Caves Rd., Suite 130, Bee Cave, TX 78738 | 2018-08-10 |
| 1710479530 | Herbert A Fritsche Jr. | Pathology | 12117 Bee Caves Road, Building 3 Suite 100, Austin, TX 78738 | 2018-06-06 |
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| 1700397809 | Katrina Balangue | Speech-Language Pathologist | 3595 Ranch Road 620 S Unit 220, Austin, TX 78738 | 2017-10-16 |
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| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
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|---|---|---|---|---|
| 1962761999 | Lrmc Cardiology, Inc. | Internal Medicine | 100 Medical Parkway, Lakeway, TX 78734 | 2012-05-11 |
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| 1891251104 | Woodlands Elite Cardiology, Pllc | Internal Medicine | 150 Pine Forest Dr Ste 702, Shenandoah, TX 77384-5317 | 2019-02-12 |
| 1033684113 | Summit Heart and Vascular Pllc | Internal Medicine | 6138 Precinct Line Rd Ste 100, Hurst, TX 76054-2610 | 2018-10-04 |
| 1104329440 | Deerbrook Cath Lab LLC | Internal Medicine | 18450 Hwy 59 Suite 101, Humble, TX 77338 | 2018-03-13 |
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| 1346758695 | Cardiac Cin of North Texas | Internal Medicine | 6565 N Macarthur Blvd Ste 225c, Irving, TX 75039-2490 | 2018-01-19 |
| 1487162368 | Cardiac Cin of West Texas LLC | Internal Medicine | 18911c Hardy Oak Blvd, San Antonio, TX 78258-4966 | 2018-01-13 |
| 1114435096 | Cardiac Cin of Austin LLC | Internal Medicine | 401 Congress Ave Ste 1540c, Austin, TX 78701-4071 | 2018-01-13 |
| 1275040925 | Prime Heart and Vascular, Pllc | Internal Medicine | 2633 Dallas Pkwy Ste 100, Plano, TX 75093-4715 | 2018-01-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.