NPIMap

Organization Active NPI

Univ of MD Pathology Associates P a

  • Clinical Medical Laboratory
  • Baltimore, MD
National Provider Identifier
1164455010
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
408 Issued in MD
Legal business name
UNIV OF MD PATHOLOGY ASSOCIATES P A
Practice address
419 W Redwood St Ste 60
Baltimore, MD 21201-1757
Phone
(667) 214-1444
Fax
(410) 328-0929
NPI assigned
Jul 7, 2006
Last updated
Dec 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Authorized official

Name
Dr. John C Papadimitriou, M.D.NPI 1760411672
Title
Director Surgical Pathology
Phone
(410) 328-5555

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
Clinical Medical Laboratory 291U00000X 418 MD
Clinical Medical Laboratory 291U00000X 408 MD Primary

Addresses

Primary practice location

419 W Redwood St Ste 60
Baltimore, MD 21201-1757

Mailing address

PO Box 64592
Baltimore, MD 21264-4592
Phone (667) 214-1610

Other practice location 1

655 W Baltimore St Rm 3-009
Baltimore, MD 21201-1509
Phone (410) 706-3597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040226001249 MD Part B Supplier - Clinic/Group Practice 7517853377 Receives reassigned benefits from 29 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Easton, MD; Towson, MD; Queenstown, MD; La Plata, MD; Glen Burnie, MD; Chestertown, MD; Cambridge, MD; Baltimore, MD
O20061219000134 MD Part B Supplier - Independent Clinical Laboratory 7517853377 Practice locations: Baltimore, MD; Easton, MD

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 12

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
21D0726008Univ of MD Medical Group PA419 W Redwood Street Suite 600, Baltimore, MD 21201Certificate of waiverAug 31, 2026
21D2027356Univ of MD SCH of Med Translational Genomics Lab655 West Baltimore Street BRB-7-036-7-040,7-047, Baltimore, MD 21201AccreditationJan 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Univ of MD Path Assoc P17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

419 W Redwood St
Ste 130
Baltimore, MD 21201
Phone (410) 328-3408

419 W Redwood St
Ste 60
Baltimore, MD 21201
Phone (667) 214-1444

655 W Baltimore St
Rm 3009
Baltimore, MD 21201
Phone (410) 706-3597

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1164455010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64592",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644592",
            "telephone_number": "667-214-1610",
            "fax_number": "410-328-0929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 W REDWOOD ST STE 60",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011757",
            "telephone_number": "667-214-1444",
            "fax_number": "410-328-0929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W Baltimore St Rm 3-009",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011509",
            "country_code": "US",
            "telephone_number": "410-706-3597",
            "fax_number": "410-706-3596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNIV OF MD PATHOLOGY ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "PAPADIMITRIOU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR SURGICAL PATHOLOGY",
        "authorized_official_telephone_number": "410-328-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "418",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.