NPIMap

Organization Active NPI

Bakotic Pathology Associates, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Alpharetta, GA
National Provider Identifier
1275858524
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
060-339 Issued in GA
Legal business name
BAKOTIC PATHOLOGY ASSOCIATES, LLC
Practice address
6240 Shiloh Rd
Alpharetta, GA 30005-8347
Phone
(855) 245-2256
Fax
(770) 292-9331
NPI assigned
Mar 30, 2010
Last updated
Dec 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Authorized official

Name
Scott Bakotic
Title
Cfo
Phone
(877) 376-7284

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 060-339 GA Primary

Addresses

Primary practice location

6240 Shiloh Rd
Alpharetta, GA 30005-8347

Mailing address

PO Box 740209
Atlanta, GA 30374-0209
Phone (855) 245-2256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090618000019 GA Part B Supplier - Clinic/Group Practice 9436218617 Receives reassigned benefits from 9 practitioners
Practice locations: Alpharetta, GA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Bakotic Pathology Servs3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6240 Shiloh Rd
Alpharetta, GA 30005
Phone (855) 245-2256

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1275858524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740209",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303740209",
            "telephone_number": "855-245-2256",
            "fax_number": "770-292-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6240 SHILOH RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058347",
            "telephone_number": "855-245-2256",
            "fax_number": "770-292-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKOTIC PATHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-30",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "BAKOTIC",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-376-7284"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "060-339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.