Individual provider Active NPI

Christine Geronimo, D.O.

  • Family Medicine Physician
  • Middle Island, NY
National Provider Identifier
1598914327
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
240447 Issued in NY
Practice address
225 Middle Country Rd
Suite 3
Middle Island, NY 11953-2553
Phone
(631) 775-8850
Fax
(631) 775-8852
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 240447 NY Primary

Addresses

Primary practice location

225 Middle Country Rd
Suite 3
Middle Island, NY 11953-2553

Mailing address

225 Middle Country Rd
Suite 3
Middle Island, NY 11953-2553
Phone (631) 775-8850

Other identifiers 1

IdentifierTypeStateIssuer
1841579562OtherNYGROUP NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20090609000371 NY Practitioner - Family Practice 1759431901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

225 Middle Country Rd
Suite 3
Middle Island, NY 11953-2553
Phone (631) 775-8850

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240447NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Family Health & Medicine, PC Family Medicine Past Accepting new patients

Organizations & group practices 2

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1598914327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 MIDDLE COUNTRY RD",
            "address_2": "SUITE 3",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532553",
            "telephone_number": "631-775-8850",
            "fax_number": "631-775-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MIDDLE COUNTRY RD",
            "address_2": "SUITE 3",
            "city": "MIDDLE ISLAND",
            "state": "NY",
            "postal_code": "119532553",
            "telephone_number": "631-775-8850",
            "fax_number": "631-775-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERONIMO",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "240447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1841579562",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middle Island, NY

Sources for this page

Verify at the official NPI Registry.