NPIMap

Organization Active NPI

Bakotic Pathology Associates, LLC

  • Clinical Medical Laboratory
  • Alpharetta, GA
National Provider Identifier
1184814014
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
060339 Issued in GA
Legal business name
BAKOTIC PATHOLOGY ASSOCIATES, LLC
Practice address
6240 Shiloh Road
Alpharetta, GA 30005
Phone
(770) 475-0379
Fax
(770) 475-0528
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Scott Bakotic
Title
Cfo
Phone
(855) 422-5628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 060339 GA Primary

Addresses

Primary practice location

6240 Shiloh Road
Alpharetta, GA 30005

Mailing address

6240 Shiloh Road
Alpharetta, GA 30005
Phone (770) 475-0379

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090106000231 GA Part B Supplier - Independent Clinical Laboratory 9436218617 Receives reassigned benefits from 1 practitioner
Practice locations: Alpharetta, GA

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1184814014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 SHILOH ROAD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-475-0379",
            "fax_number": "770-475-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 SHILOH ROAD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-475-0379",
            "fax_number": "770-475-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKOTIC PATHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "BAKOTIC",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "855-422-5628"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "060339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.