Individual provider Active NPI

Jorge Luis Juncos, M.D.

  • Neurology Physician
  • Cumming, GA
National Provider Identifier
1184801383
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
030113 Issued in GA
Practice address
1100 Northside Forsyth Dr Ste 210
Cumming, GA 30041-6016
Phone
(404) 683-1017
Fax
(404) 698-3463
NPI assigned
Jan 30, 2008
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 30113 GA
Neurology Physician 2084N0400X 030113 GA Primary

Addresses

Primary practice location

1100 Northside Forsyth Dr Ste 210
Cumming, GA 30041-6016

Mailing address

1100 Northside Forsyth Dr Ste 210
Cumming, GA 30041-6016
Phone (404) 683-1017

Other identifiers 2

IdentifierTypeStateIssuer
000391069BMedicaidGA
000391069GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080521000728 GA Practitioner - Neurology 0547339160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Columbia University College of Physicians and Surgeons, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1100 Northside Forsyth Dr
Suite 210
Cumming, GA 30041-6016
Phone (470) 239-3602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
030113GAMDNeurology Physician
30113GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Juncos Neuro Consulting, LLC Neurology CurrentSince Mar 24, 2024 Accepting new patients

Locations

1100 Northside Forsyth Dr
Ste 210
Cumming, GA 30041
Phone (470) 239-3602

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1184801383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DR STE 210",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416016",
            "telephone_number": "404-683-1017",
            "fax_number": "404-698-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 NORTHSIDE FORSYTH DR STE 210",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416016",
            "telephone_number": "404-683-1017",
            "fax_number": "404-698-3463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNCOS",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "30113",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "030113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000391069B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000391069G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.