NPIMap

Organization Active NPI

Diagnostic Pathology Consultants PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Voorhees, NJ
National Provider Identifier
1245239805
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
DIAGNOSTIC PATHOLOGY CONSULTANTS PA
Practice address
100 Bowman Drive
Pathology Dept
Voorhees, NJ 08043-0804
Phone
(856) 247-3174
NPI assigned
Jul 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
David Obando, M.D.NPI 1932109063
Title
Head Pathologist
Phone
(865) 325-3184

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 1

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

Addresses

Primary practice location

100 Bowman Drive
Pathology Dept
Voorhees, NJ 08043-0804

Mailing address

100 Bowman Drive
Pathology Dept
Voorhees, NJ 08043-0100
Phone (856) 274-3174

Other identifiers 2

IdentifierTypeStateIssuer
2001257497OtherNJBLUE CROSS BLUE SHIELD
0036641MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040830000896 NJ Part B Supplier - Clinic/Group Practice 9638144983 Receives reassigned benefits from 10 practitioners
Practice locations: Willingboro, NJ; Voorhees, NJ; Salem, NJ; Mount Holly, NJ; Marlton, NJ; Camden, NJ; Berlin, NJ

National Provider Directory

National Provider Directory

Locations

1919 S Highland Ave
Ste 210A
Lombard, IL 60148

Practitioners & affiliated clinicians

Practitioners 10

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": "1121558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1245239805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BOWMAN DRIVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080430100",
            "telephone_number": "856-274-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BOWMAN DRIVE",
            "address_2": "PATHOLOGY DEPT",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080430804",
            "telephone_number": "856-247-3174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC PATHOLOGY CONSULTANTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-17",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "OBANDO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "HEAD PATHOLOGIST",
        "authorized_official_telephone_number": "865-325-3184",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2001257497",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036641",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.