NPIMap

Organization Active NPI

Institute for Dermatopathology, Inc.

  • Clinical Medical Laboratory
  • Flourtown, PA
National Provider Identifier
1093595829
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
INSTITUTE FOR DERMATOPATHOLOGY, INC.
Practice address
6102 Creekside Dr
Flourtown, PA 19031-1407
Phone
(610) 550-3000
NPI assigned
Sep 29, 2023
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
AMERIPATH INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Kristie M Dolan
Title
Vice President
Phone
(973) 723-4736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

6102 Creekside Dr
Flourtown, PA 19031-1407

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041228000523 PA Part B Supplier - Independent Clinical Laboratory 6800854571 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pittsburgh, PA; Newtown Square, PA; Flourtown, PA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2290587Institute for Dermatopathology Inc6102 Creekside Drive, Flourtown, PA 19031ComplianceFeb 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Institute for Dermatopathology Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

20 Ash St
Ste 310
Conshohocken, PA 19428
Phone (610) 260-0555

3805 West Chester Pike
Ste 120
Newtown Square, PA 19073
Phone (610) 550-3000

8002 Discovery Dr
Rm 422
Richmond, VA 23229
Phone (877) 214-0147

Practitioners & affiliated clinicians

Practitioners 28

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 28

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1093595829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6102 CREEKSIDE DR",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "190311407",
            "telephone_number": "610-550-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR DERMATOPATHOLOGY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERIPATH INC",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "KRISTIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "973-723-4736"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flourtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.