Organization Active NPI

Internal Medicine and Geriatrics Associates PLLC

  • General Practice Physician
  • Holbrook, NY
National Provider Identifier
1659589273
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INTERNAL MEDICINE AND GERIATRICS ASSOCIATES PLLC
Practice address
233 Union Ave Ste 206
Holbrook, NY 11741-1821
Phone
(631) 588-4888
Fax
(631) 588-4840
NPI assigned
May 18, 2007
Last updated
Mar 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Jahanzeb Chaudhry, MDNPI 1235214271
Title
Owner
Phone
(631) 588-4888

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
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

233 Union Ave Ste 206
Holbrook, NY 11741-1821

Mailing address

233 Union Ave Ste 206
Holbrook, NY 11741-1821
Phone (631) 588-4888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041124000286 NY Part B Supplier - Clinic/Group Practice 5193780633 Receives reassigned benefits from 2 practitioners
Practice locations: Holbrook, NY

National Provider Directory

National Provider Directory
Tax ID family
Internal Medicine and Geriatrics Associates PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

520 Franklin Ave
Ste 111
Garden City, NY 11530
Phone (516) 248-6626

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1659589273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 UNION AVE STE 206",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411821",
            "telephone_number": "631-588-4888",
            "fax_number": "631-588-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 UNION AVE STE 206",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411821",
            "telephone_number": "631-588-4888",
            "fax_number": "631-588-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE AND GERIATRICS ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "CHAUDHRY",
        "authorized_official_first_name": "JAHANZEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-588-4888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.