Geriatric Professional Group, Llc - Medicare Primary Care in Bridgeport, CT

Geriatric Professional Group, Llc is a medicare enrolled primary clinic (Internal Medicine) in Bridgeport, Connecticut. The current practice location for Geriatric Professional Group, Llc is 4200 Park Ave, Bridgeport, Connecticut. For appointments, you can reach them via phone at (203) 365-6473. The mailing address for Geriatric Professional Group, Llc is 4200 Park Ave, Bridgeport, Connecticut and phone number is (203) 365-6473.

Geriatric Professional Group, Llc is licensed to practice in Connecticut (license number ). The clinic also participates in the medicare program and its NPI number is 1932295953. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (203) 365-6473.

Contact Information

Geriatric Professional Group, Llc
4200 Park Ave
Bridgeport
CT 06604-1049
(203) 365-6473
(203) 396-1039

Primary Care Clinic Profile

Full NameGeriatric Professional Group, Llc
SpecialityInternal Medicine
Location4200 Park Ave, Bridgeport, Connecticut
Authorized Official Name and PositionAndrew H Banoff (PRESIDENT/CEO)
Authorized Official Contact2033656400
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Geriatric Professional Group, Llc
4200 Park Ave
Bridgeport
CT 06604-1049

Ph: (203) 365-6473
Geriatric Professional Group, Llc
4200 Park Ave
Bridgeport
CT 06604-1049

Ph: (203) 365-6473

NPI Details:

NPI Number1932295953
Provider Enumeration Date10/05/2006
Last Update Date11/07/2016

Medicare PECOS Information:

Medicare PECOS PAC ID8628973112
Medicare Enrollment IDO20031208000180

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Medical Identifiers

Medical identifiers for Geriatric Professional Group, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1932295953NPI-NPPES
9233MedicaidCT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (Connecticut)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Geriatric Professional Group, Llc acts as a billing entity for following providers:
Provider NameJoseph F Fickes
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1902838329
PECOS PAC ID: 4981690286
Enrollment ID: I20040422000552

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Provider NamePamela B Hoffman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366548778
PECOS PAC ID: 6507762093
Enrollment ID: I20040422000844

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Provider NameRandi R Diamond
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1700946472
PECOS PAC ID: 8426044363
Enrollment ID: I20040424000042

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Provider NameVittoria G Gassman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1013987700
PECOS PAC ID: 4385667658
Enrollment ID: I20060112000614

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Provider NameKenneth Fine
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063508349
PECOS PAC ID: 5395743140
Enrollment ID: I20061110000169

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Provider NameAllison B Ostroff
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1720262397
PECOS PAC ID: 5395860126
Enrollment ID: I20100916000340

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Internal Medicine in Bridgeport, CT

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Phone: 203-916-5151    Fax: 203-916-5155
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Practice Location: 978 E Main St, Bridgeport, CT 06608
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Ambulatory Services Bridgeport Hospital
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Practice Location: 790 Central Ave, Bridgeport, CT 06607
Phone: 203-332-4567    Fax: 203-332-0376

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