NPIMap

Organization Active NPI

Bayless Pathmark Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Euclid, OH
National Provider Identifier
1235328121
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
BAYLESS PATHMARK INC
Practice address
18901 Lakeshore Blvd
Euclid, OH 44119
Phone
(440) 627-2040
Fax
(440) 627-2070
NPI assigned
Oct 17, 2007
Organization subpart
Yes
Parent organization
BAYLESS PATHMARK INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Authorized official

Name
Dr. Yilan Chang
Title
President
Phone
(440) 826-0384

Specialties & licenses 1

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

Addresses

Primary practice location

18901 Lakeshore Blvd
Euclid, OH 44119

Mailing address

19250 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3348
Phone (440) 826-0384

Other identifiers 1

IdentifierTypeStateIssuer
0990709MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000010 OH Part B Supplier - Clinic/Group Practice 3577469659 Receives reassigned benefits from 9 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alliance, OH; Bellevue, OH; Middleburg Heights, OH; Norwalk, OH

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
Pathmark Inc Hillcrest

NPI Registry JSON

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547337600000",
    "number": "1235328121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19250 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303348",
            "telephone_number": "440-826-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18901 LAKESHORE BLVD",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "44119",
            "telephone_number": "440-627-2040",
            "fax_number": "440-627-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLESS PATHMARK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAYLESS PATHMARK INC",
        "enumeration_date": "2007-10-17",
        "last_updated": "2019-01-13",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "YILAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-826-0384",
        "authorized_official_name_prefix": "Dr."
    },
    "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": "0990709",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.