Individual provider Active NPI

Stavros Angelos Georganos, M.D.

  • Neuroradiology Physician
  • Stanford, CA
National Provider Identifier
1578788295
Registry record updated Sep 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
A96207 Issued in CA
Practice address
Stanford University School of Medicine, Radiology
300 Pasteur Drive , S-060
Stanford, CA 94305-5105
Phone
(650) 497-8000
NPI assigned
Apr 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X A96207 CA Primary

Addresses

Primary practice location

Stanford University School of Medicine, Radiology
300 Pasteur Drive , S-060
Stanford, CA 94305-5105

Mailing address

222 Washington Ave
Apt 19
Santa Monica, CA 90403-3636
Phone (310) 871-4248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A96207CAMDNeuroradiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253145600000",
    "number": "1578788295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 WASHINGTON AVE",
            "address_2": "APT 19",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904033636",
            "telephone_number": "310-871-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STANFORD UNIVERSITY SCHOOL OF MEDICINE, RADIOLOGY",
            "address_2": "300 PASTEUR DRIVE , S-060",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943055105",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGANOS",
        "first_name": "STAVROS",
        "middle_name": "ANGELOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2009-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A96207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.