NPIMap

Organization Active NPI

The Council on Aging of Martin County Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Stuart, FL
National Provider Identifier
1770855405
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
THE COUNCIL ON AGING OF MARTIN COUNTY INC
Practice address
900 SE Salerno Rd
Stuart, FL 34997-6405
Phone
(772) 223-7803
Fax
(772) 463-0091
NPI assigned
Jan 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Authorized official

Name
Kenneth Kaneski
Title
Directo of Finance
Phone
(772) 223-7803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

900 SE Salerno Rd
Stuart, FL 34997-6405

Mailing address

900 SE Salerno Rd
Stuart, FL 34997-6405
Phone (772) 223-7803

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120713000213 FL Part B Supplier - Clinic/Group Practice 0648334953 Receives reassigned benefits from 7 practitioners
Practice locations: Stuart, FL

National Provider Directory

National Provider Directory
Tax ID family
The Council on Aging of Martin County Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

900 SE Salerno Rd
Stuart, FL 34997
Phone (772) 223-7803

Practitioners & affiliated clinicians

Practitioners 10

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": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341964800000",
    "number": "1770855405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976405",
            "telephone_number": "772-223-7803",
            "fax_number": "772-463-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SE SALERNO RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976405",
            "telephone_number": "772-223-7803",
            "fax_number": "772-463-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COUNCIL ON AGING OF MARTIN COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-07-11",
        "status": "A",
        "authorized_official_last_name": "KANESKI",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTO OF FINANCE",
        "authorized_official_telephone_number": "772-223-7803"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.