NPIMap

Organization Active NPI

Geriatric & Palliative Specialist PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Oswego, NY
National Provider Identifier
1558796243
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
246837 Issued in NY
Legal business name
GERIATRIC & PALLIATIVE SPECIALIST PC
Practice address
101 W Utica St
Suite C
Oswego, NY 13126-3165
Phone
(315) 216-6865
Fax
(315) 216-6867
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Renante Ignacio, M.D.NPI 1861485849
Title
Owner/Physician
Phone
(315) 216-4641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X 246837 NY Primary

Addresses

Primary practice location

101 W Utica St
Suite C
Oswego, NY 13126-3165

Mailing address

101 W Utica St
Suite C
Oswego, NY 13126-3165
Phone (315) 216-6865

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140910001036 NY Part B Supplier - Clinic/Group Practice 6103045950 Receives reassigned benefits from 8 practitioners
Practice locations: Oswego, NY

National Provider Directory

National Provider Directory

Locations

101 W Utica St
Ste C
Oswego, NY 13126
Phone (315) 216-4641

Practitioners & affiliated clinicians

Practitioners 8

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": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1558796243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UTICA ST",
            "address_2": "SUITE C",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263165",
            "telephone_number": "315-216-6865",
            "fax_number": "315-216-6867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UTICA ST",
            "address_2": "SUITE C",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "131263165",
            "telephone_number": "315-216-6865",
            "fax_number": "315-216-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC & PALLIATIVE SPECIALIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "IGNACIO",
        "authorized_official_first_name": "RENANTE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "315-216-4641",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "246837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; 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.