Summit Pathology
Organization Active NPI Anatomic Pathology & Clinical Pathology Physician · Sterling, CO
NPI 1285419929 · NPPES record last updated Aug 30, 2023
Key facts
- NPI
- 1285419929
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- Legal business name
- SUMMIT PATHOLOGY
- Practice address
- 615 Fairhurst St
Sterling, CO 80751-4523 - Phone
- (970) 521-3160
- NPI assigned
- Aug 30, 2023
- Organization subpart
- No
Authorized official
- Name
- Jeff Christinson
- Title
- Ceo
- Phone
- (970) 212-0557
Other NPIs on the same Medicare enrollment 6
Corporate family (same tax ID) 10
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 06D2287841 | Summit Pathology | Registration | Jul 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040331000656 | CO | Part B Supplier - Clinic/Group Practice | 3971595968 |
Receives reassigned benefits from 30 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Loveland, CO; Sterling, CO; Greeley, CO; Fort Collins, CO |
National Provider Directory
- Tax ID family
- Summit Pathology
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X | Yes |
Addresses
Primary practice location
615 Fairhurst St
Sterling, CO 80751-4523
Mailing address
5802 Wright Dr
Loveland, CO 80538-8806
NPI Registry JSON
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693353600000",
"number": "1285419929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5802 WRIGHT DR",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805388806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 FAIRHURST ST",
"city": "STERLING",
"state": "CO",
"postal_code": "807514523",
"telephone_number": "970-521-3160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMIT PATHOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-30",
"last_updated": "2023-08-30",
"certification_date": "2023-08-30",
"status": "A",
"authorized_official_last_name": "CHRISTINSON",
"authorized_official_first_name": "JEFF",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "970-212-0557"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, CO
- Rebecca Stieb
- Jo Ann Stock
- Nichole Stone
- Tiffany Ann Storch
- Pamela Strong
- Summit Treatment Services, Inc.
- Sunrise Recovery Center
- Nicole Suppes
- Kimberly Ann Suter
- Christopher A Swenson
All providers in Sterling, CO · Anatomic Pathology & Clinical Pathology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.