Geriatrics and Longevity Treatment Specialist, PC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC

Practice address

810 Main St
Hackensack, NJ 07601-4847

Phone

(201) 663-7375

NPI assigned

Oct 19, 2011

Last updated

Nov 13, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stefanos G Pantagis, MDNPI 1235212879

Title

Owner

Phone

(201) 663-7375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stefanos Pantagis, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1235212879
  Medicare reassignment Care Compare group NPD Authorized official
• Amy E. Donoghue, LCSW

  • Clinical Social Worker
  • Bernardsville, NJ
  • NPI 1841343498
  Medicare reassignment Care Compare group NPD
• Colleen Doran

  • Clinical Social Worker
  • Hackensack, NJ
  • NPI 1609204957
  Medicare reassignment Care Compare group NPD
• Dana A Hayes, LCSW

  • Social Worker
  • Bergenfield, NJ
  • NPI 1285157479
  Medicare reassignment Care Compare group NPD
• Christian Ortiz

  • Gerontology Nurse Practitioner
  • Hackensack, NJ
  • NPI 1427723501
  Medicare reassignment Care Compare group NPD
• Jessica Ortiz

  • Gerontology Nurse Practitioner
  • Hackensack, NJ
  • NPI 1700361698
  Medicare reassignment Care Compare group NPD
• Beverly Piparo, LCSW

  • Clinical Social Worker
  • Hackensack, NJ
  • NPI 1255973137
  Medicare reassignment Care Compare group NPD
• Tamar Shicly

  • Family Nurse Practitioner
  • Teaneck, NJ
  • NPI 1427430149
  Medicare reassignment Care Compare group NPD
• Mary L Simmons, APN

  • Adult Health Nurse Practitioner
  • Ridgewood, NJ
  • NPI 1386040905
  Medicare reassignment Care Compare group NPD
• Michael Davis Abbey, APN

  • Adult Health Nurse Practitioner
  • Hackensack, NJ
  • NPI 1942743752
  Medicare reassignment NPD
• Susanthi Gunadasa, MD, MBBS

  • Internal Medicine Physician
  • Hackensack, NJ
  • NPI 1639331861
  Medicare reassignment NPD
• Felicidad Marie Guzman, RN, BSN, MSN, NP-C

  • Nurse Practitioner
  • Basking Ridge, NJ
  • NPI 1083199160
  Medicare reassignment NPD

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384300800000",
    "number": "1306121504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014847",
            "telephone_number": "201-663-7375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014847",
            "telephone_number": "201-663-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRICS AND LONGEVITY TREATMENT SPECIALIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2013-11-13",
        "status": "A",
        "authorized_official_last_name": "PANTAGIS",
        "authorized_official_first_name": "STEFANOS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-663-7375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenny Syriac George, NP-C
• Marina Chingchun George, N.P.
• Judi R Gerardis, MD
• Elise Nicole Gerdes
• Geriatric Care Solutions
• Amy Ileana German, LAC
• Angelica Germinario
• Carla Ann Germinario, M.D.
• Julius Gerstel, DDS
• Shira Jolene Gertz, M.D.

• Geriatric Medicine (Family Medicine) Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2013; 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.