NPIMap

Organization Active NPI

Cascade Pathology Services, Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, OR
National Provider Identifier
1154465656
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
CASCADE PATHOLOGY SERVICES, CORP
Practice address
1225 NE 2ND Ave
Portland, OR 97232-2003
Phone
(503) 413-5049
Fax
(503) 413-5054
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Authorized official

Name
Michael Grattendick, CFO
Title
Cfo
Phone
(561) 514-5822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1225 NE 2ND Ave
Portland, OR 97232-2003

Mailing address

PO Box 4207
Portland, OR 97208-4207
Phone (503) 268-4850

Other identifiers 1

IdentifierTypeStateIssuer
037486MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511000620 OR Part B Supplier - Clinic/Group Practice 4981693215 Receives reassigned benefits from 26 practitioners
Practice locations: Portland, OR; Tualatin, OR; Salem, OR; Gresham, OR

Other NPIs with the same Medicare PAC ID 1

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

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
38D2117899Cascade Pathology Services Central Lab1225 NE Second Ave, BLDG B, Portland, OR 97232AccreditationJul 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Cascade Pathology Services Corp2 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.

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1154465656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4207",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084207",
            "telephone_number": "503-268-4850",
            "fax_number": "503-268-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 NE 2ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322003",
            "telephone_number": "503-413-5049",
            "fax_number": "503-413-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE PATHOLOGY SERVICES, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "GRATTENDICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-514-5822",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037486",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.