Individual provider Active NPI

Gerasimos Papadatos, MD

  • Specialist
  • Astoria, NY
National Provider Identifier
1669433983
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
142263 Issued in NY
Practice address
2310 30TH Ave
Astoria, NY 11102-3396
Phone
(718) 626-7500
Fax
(718) 204-7005
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 142263 NY Primary

Addresses

Primary practice location

2310 30TH Ave
Astoria, NY 11102-3396

Mailing address

201 E 19TH St
Suite 5B
New York, NY 10003-2604
Phone (718) 626-7500

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
142263NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1669433983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 19TH ST",
            "address_2": "SUITE 5B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032604",
            "telephone_number": "718-626-7500",
            "fax_number": "718-204-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111023396",
            "telephone_number": "718-626-7500",
            "fax_number": "718-204-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPADATOS",
        "first_name": "GERASIMOS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "142263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.