NPIMap

Organization Active NPI

Geriatrica, LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Athens, GA
National Provider Identifier
1639759558
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GERIATRICA, LLC
Practice address
254 Moss Side Dr
Athens, GA 30607-2109
Phone
(646) 515-2050
NPI assigned
Apr 13, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Dr. Yolin A Bueno, MDNPI 1194061150
Title
Co-Founder
Phone
(646) 515-2050

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: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

254 Moss Side Dr
Athens, GA 30607-2109

Mailing address

254 Moss Side Dr
Athens, GA 30607-2109
Phone (646) 515-2050

Other identifiers 3

IdentifierTypeStateIssuer
1194061150MedicaidNY
1447548102MedicaidCT
1528356359MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Athens

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1639759558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 MOSS SIDE DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072109",
            "telephone_number": "646-515-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 MOSS SIDE DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306072109",
            "telephone_number": "646-515-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRICA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "BUENO",
        "authorized_official_first_name": "YOLIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "646-515-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194061150",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447548102",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528356359",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Athens",
            "affiliation": "N",
            "address_1": "254 Moss Side Dr",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306072109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.