Individual provider Active NPI

Lefkos B Aftonomos, M.D.

  • Physical Medicine & Rehabilitation Physician
  • San Mateo, CA
National Provider Identifier
1972544088
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G37819 Issued in CA
Practice address
34 N San Mateo Dr
Suite 2
San Mateo, CA 94401-2824
Phone
(650) 513-6651
Fax
(650) 350-4395
NPI assigned
Jun 9, 2006
Last updated
Dec 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G37819 CA Primary

Addresses

Primary practice location

34 N San Mateo Dr
Suite 2
San Mateo, CA 94401-2824

Mailing address

730 Polhemus Rd
Suite 203
San Mateo, CA 94402-3976
Phone (650) 356-0076

Other identifiers 1

IdentifierTypeStateIssuer
00G378190MedicaidCA

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
G37819CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoyman Hong, MD a Prof Med Corp Physical Medicine & Rehabilitation PastSince Nov 15, 2007 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1972544088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 POLHEMUS RD",
            "address_2": "SUITE 203",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023976",
            "telephone_number": "650-356-0076",
            "fax_number": "650-349-2762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N SAN MATEO DR",
            "address_2": "SUITE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012824",
            "telephone_number": "650-513-6651",
            "fax_number": "650-350-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFTONOMOS",
        "first_name": "LEFKOS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G37819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G378190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.