NPIMap

Organization Active NPI

State University of Iowa

Doing business as Pathology Referral Testing Billing Dept

  • Clinical Medical Laboratory
  • Iowa City, IA
National Provider Identifier
1265433676
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
16D0664625 Issued in IA
Legal business name
STATE UNIVERSITY OF IOWA
Doing business as
Pathology Referral Testing Billing Dept
Practice address
200 Hawkins Dr
C660 GH
Iowa City, IA 52242-1009
Phone
(319) 384-9647
Fax
(319) 384-5184
NPI assigned
Aug 9, 2005
Last updated
May 2, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE UNIVERSITY OF IOWAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Authorized official

Name
Michael B Cohen, MDNPI 1851389456
Title
Head
Phone
(319) 384-9609

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
Clinical Medical Laboratory 291U00000X 16D0664625 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
C660 GH
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
C660 GH
Iowa City, IA 52242-1009
Phone (319) 384-9647

Other identifiers 2

IdentifierTypeStateIssuer
33898OtherIAWELLMARK BC/BS
0291393MedicaidIA

Other names 1

  • Pathology Referral Testing Billing Dept Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031107000060 IA Part B Supplier - Clinic/Group Practice 7618884230 Receives reassigned benefits from 2,348 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 36

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

View all 36

National Provider Directory

National Provider Directory
Tax ID family
Univ of Ia Hosps Clins57 organizations share this tax ID, including this one
Part of
Univ of Ia Hosps Clins

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

105 E 9th St
Iowa City, IA 52241
Phone (319) 467-2000

200 Hawkins Dr
#C660
Iowa City, IA 52242
Phone (319) 356-2991

Practitioners & affiliated clinicians

Practitioners 89

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 89

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1265433676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "C660 GH",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-384-9647",
            "fax_number": "319-384-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "C660 GH",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-384-9647",
            "fax_number": "319-384-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE UNIVERSITY OF IOWA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE UNIVERSITY OF IOWA",
        "enumeration_date": "2005-08-09",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "HEAD",
        "authorized_official_telephone_number": "319-384-9609",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IA",
            "license": "16D0664625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "33898",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0291393",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathology Referral Testing Billing Dept",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.