Geromed, LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

GEROMED, LLC

Practice address

4675 S Grand Blvd
Saint Louis, MO 63111-1462

Phone

(314) 752-8600

Fax

(314) 752-8601

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tony Thien Tang, M. D.NPI 1417040114

Title

Owner

Phone

(314) 752-8600

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Tony Thien Tang, M. D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1417040114
  Medicare reassignment Care Compare group NPD Authorized official
• Chantri Trinh, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Saint Louis, MO
  • NPI 1023026804
  Medicare reassignment Care Compare group NPD
• Yorvoll Gardner, NP

  • Adult Health Nurse Practitioner
  • Hazelwood, MO
  • NPI 1508381039

  Geriatric Medicine

  NPD (past)

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1184755118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631111462",
            "telephone_number": "314-752-8600",
            "fax_number": "314-752-8601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631111462",
            "telephone_number": "314-752-8600",
            "fax_number": "314-752-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEROMED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "TANG",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "THIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-752-8600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208442400",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "508753001",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208393702",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1023026804",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1417040114",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Scott German, MD
• Jennifer German, PHARMD
• Jessica Elizabeth Germanese, RD, LD
• Kevin W Germino, M.D.
• Christian Michael Germonprez
• Christopher M Geronsin, RPH
• Gerri's Adult Day Care Center, LLC
• Deborah Gersell, M.D.
• Gary Igor Gershilevich, D.D.S.
• Victoria Merrill Gershuni, MD

• Geriatric Medicine (Internal Medicine) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Geriatric Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.