NPIMap

Organization Active NPI

DCL Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Indianapolis, IN
National Provider Identifier
1063771012
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
DCL PATHOLOGY LLC
Practice address
9550 Zionsville Rd
Suite 200
Indianapolis, IN 46268-1065
Phone
(317) 874-1254
Fax
(317) 872-4193
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Dr. Carol C Eisenhut, MDNPI 1982704466
Title
Lab Director
Phone
(317) 874-1254

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0500X
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

9550 Zionsville Rd
Suite 200
Indianapolis, IN 46268-1065

Mailing address

9550 Zionsville Rd
Suite 200
Indianapolis, IN 46268-1065
Phone (317) 874-1254

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120614000192 IN Part B Supplier - Clinic/Group Practice 1850564675 Receives reassigned benefits from 5 practitioners
Practice locations: Carmel, IN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
DCL Pathology LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9550 Zionsville Rd
Ste 200
Indianapolis, IN 46268
Phone (317) 872-0116

Practitioners & affiliated clinicians

Practitioners 6

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": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1063771012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 ZIONSVILLE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681065",
            "telephone_number": "317-874-1254",
            "fax_number": "317-872-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 ZIONSVILLE RD",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681065",
            "telephone_number": "317-874-1254",
            "fax_number": "317-872-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DCL PATHOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "EISENHUT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "317-874-1254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.