Stat-Genetik, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1263 Issued in PR

Legal business name

STAT-GENETIK, INC

Doing business as

High Profile Laboratory II

Practice address

Ramirez de Arellano Avenue Esquina Madrid
Shopping Center Torrimar Local 5
Guaynabo, PR 00969

Phone

(787) 523-1922

Fax

(787) 523-1926

NPI assigned

Jun 20, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Carmen Ripoll, B.S.M.T

Title

Laboratory Director

Phone

(787) 523-1922

Specialties & licenses 1

Addresses

Other names 1

• High Profile Laboratory II Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Stat-Genetik Inc2 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.

• Stat-Genetik, Inc

  • Clinical Medical Laboratory
  • Guaynabo, PR
  • NPI 1841067964
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Stat-Genetik, Inc

  • Clinical Medical Laboratory
  • Guaynabo, PR
  • NPI 1841067964
  NPPES parent name

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1235492794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 355 EMERALDA AVENUE 405",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694457",
            "telephone_number": "787-523-1922",
            "fax_number": "787-523-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RAMIREZ DE ARELLANO AVENUE ESQUINA MADRID",
            "address_2": "SHOPPING CENTER TORRIMAR LOCAL 5",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-523-1922",
            "fax_number": "787-523-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT-GENETIK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "RIPOLL",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "787-523-1922",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S.M.T"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Profile Laboratory II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.