Active NPI
Renuka Pathi, MD
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
National Provider Identifier
1063666543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 247870
- Practice address
- 22216 N 36TH St
Phoenix, AZ 85050-7396 - Phone
- (602) 606-7375
- NPI assigned
- Nov 10, 2008
- Last updated
- Feb 25, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 247870 | NY | Primary |
Addresses
Primary practice location
22216 N 36TH St
Phoenix, AZ 85050-7396
Mailing address
22216 N 36TH St
Phoenix, AZ 85050-7396
Phone (602) 606-7375
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
| License | State | Type | Specialty |
|---|---|---|---|
| 247870 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361750400000",
"number": "1063666543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22216 N 36TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850507396",
"telephone_number": "602-606-7375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22216 N 36TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850507396",
"telephone_number": "602-606-7375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHI",
"first_name": "RENUKA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2013-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "NY",
"license": "247870",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.