NPIMap

Organization Active NPI

Geriatric Primary Care PC

  • Internal Medicine Physician
  • Agawam, MA
National Provider Identifier
1972349090
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GERIATRIC PRIMARY CARE PC
Practice address
723 Main St
Agawam, MA 01001-2540
Phone
(413) 374-0031
Fax
(413) 384-2526
NPI assigned
Jul 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
May Awkal, MDNPI 1316181027
Title
Ceo
Phone
(860) 881-4161

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

723 Main St
Agawam, MA 01001-2540

Mailing address

723 Main St
Agawam, MA 01001-2540
Phone (413) 374-0031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240724000883 MA Part B Supplier - Clinic/Group Practice 7315483583 Receives reassigned benefits from 14 practitioners
Practice locations: Leeds, MA; Longmeadow, MA; Ludlow, MA; Northampton, MA; Springfield, MA; Ware, MA; West Springfield, MA; Westfield, MA…

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1972349090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 MAIN ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012540",
            "telephone_number": "413-374-0031",
            "fax_number": "413-384-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 MAIN ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010012540",
            "telephone_number": "413-374-0031",
            "fax_number": "413-384-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "AWKAL",
        "authorized_official_first_name": "MAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-881-4161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agawam, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.