Surgical Pathology Laboratories PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800014408 Issued in FL

Legal business name

SURGICAL PATHOLOGY LABORATORIES PA

Practice address

8455 66TH St
Pinellas Park, FL 33781-1206

Phone

(727) 545-2339

Fax

(727) 545-1644

NPI assigned

Feb 15, 2006

Last updated

Jun 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey J Bulson, D.O.NPI 1427150788

Title

President

Phone

(727) 545-2339

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners 10

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.

• Jeffrey J Bulson, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
  • NPI 1427150788
  Medicare reassignment Care Compare group NPD Authorized official
• Thomas K Barton, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • South Pasadena, FL
  • NPI 1467431247
  Medicare reassignment Care Compare group NPD
• Emily Bulson, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
  • NPI 1194352708

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Richard Degregorio, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
  • NPI 1871565051
  Medicare reassignment Care Compare group NPD
• Fiona C. McPherson, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
  • NPI 1538184320
  Medicare reassignment Care Compare group NPD
• Scott Edward Miller, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Pinellas Park, FL
  • NPI 1922111699
  Medicare reassignment Care Compare group NPD
• Charles Vincent Perniciaro, M.D.

  • Dermatopathology Physician
  • Tampa, FL
  • NPI 1972557890
  Medicare reassignment Care Compare group NPD
• John P Williams, DO

  • Cytopathology Physician
  • Gulfport, FL
  • NPI 1598744393
  Medicare reassignment Care Compare group NPD
• Danielle N Fasciano, DO

  • Anatomic Pathology & Clinical Pathology Physician
  • St Petersburg, FL
  • NPI 1376997668
  Medicare reassignment Care Compare group
• Martin Gwent Lewis, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • St Petersburg, FL
  • NPI 1326070962
  Medicare reassignment NPD

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1184698086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8455 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337811206",
            "telephone_number": "727-548-7732",
            "fax_number": "727-545-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8455 66TH ST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337811206",
            "telephone_number": "727-545-2339",
            "fax_number": "727-545-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PATHOLOGY LABORATORIES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "BULSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-545-2339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800014408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277272800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "220025650",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "L9274",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80591",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suncoast Center Inc
• Suncoast Pace, Inc.
• Sunrise Retirement Home LLC
• Sunstar Village LLC
• Super Saver Pharmacy LLC (My Choice RX)
• Diane Sutliff
• Annika Svoboda, SLP
• Peter Swain, M.D.
• Christine Swartzman, APRN
• David E. Swindall, M.DIV.,LMFT

• Clinical Medical Laboratory in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.