NPIMap

Organization Active NPI

Geriatric Psychiatric Services PLLC

  • Psychiatry Physician
  • Westchester, IL
National Provider Identifier
1124273826
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GERIATRIC PSYCHIATRIC SERVICES PLLC
Practice address
1 Westbrook Corp Ctr
Suite 300
Westchester, IL 60154-5701
Phone
(708) 375-3075
Fax
(866) 227-7418
NPI assigned
Nov 21, 2008
Organization subpart
Yes
Parent organization
TOTAL CARE SOLUTIONS, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Robert A Clemente, ESQ.
Title
Admin Dir.
Phone
(586) 620-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1 Westbrook Corp Ctr
Suite 300
Westchester, IL 60154-5701

Mailing address

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090227000527 IL Part B Supplier - Clinic/Group Practice 6204837388 Receives reassigned benefits from 9 practitioners
3 other NPIs on this enrollment

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Geriatric Psychiatric PLLC8 organizations share this tax ID, including this one
Part of
Total Care Solutions SC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1124273826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39465 W 14 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771600",
            "telephone_number": "877-906-9699",
            "fax_number": "888-483-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WESTBROOK CORP CTR",
            "address_2": "SUITE 300",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601545701",
            "telephone_number": "708-375-3075",
            "fax_number": "866-227-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOTAL CARE SOLUTIONS, SC",
        "enumeration_date": "2008-11-21",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "CLEMENTE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMIN DIR.",
        "authorized_official_telephone_number": "586-620-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.