NPIMap

Organization Active NPI

Path Lab Diagnostic Services, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Galesburg, IL
National Provider Identifier
1245267673
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATH LAB DIAGNOSTIC SERVICES, LLC
Practice address
3333 N Seminary St
Galesburg, IL 61401-1251
Phone
(877) 861-9294
NPI assigned
Jun 28, 2006
Last updated
May 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Nestor Pamatmat, M.D.NPI 1245283761
Title
President
Phone
(877) 861-9294

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3333 N Seminary St
Galesburg, IL 61401-1251

Mailing address

PO Box 9518
Peoria, IL 61612-9518
Phone (877) 861-9294

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1245267673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9518",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616129518",
            "telephone_number": "877-861-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "877-861-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATH LAB DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "PAMATMAT",
        "authorized_official_first_name": "NESTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-861-9294",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.