NPIMap

Organization Active NPI

Neogenomics Laboratories Inc

  • Clinical Medical Laboratory
  • Portland, OR
National Provider Identifier
1366033862
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NEOGENOMICS LABORATORIES INC
Practice address
10560 NW Glenmore Way
Portland, OR 97229-4067
Phone
(866) 776-5907
Fax
(888) 443-4153
NPI assigned
Jan 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Kathryn Bisogno McKenzie
Title
Cfo
Phone
(239) 768-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10560 NW Glenmore Way
Portland, OR 97229-4067

Mailing address

31 Columbia
Aliso Viejo, CA 92656-1460
Phone (866) 776-5907

Other identifiers 1

IdentifierTypeStateIssuer
38D2149368OtherORCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210224002851 OR Part B Supplier - Independent Clinical Laboratory 7113011172 Practice locations: Portland, OR

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Neogenomics Laboratories17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1366033862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 COLUMBIA",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561460",
            "telephone_number": "866-776-5907",
            "fax_number": "888-443-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10560 NW GLENMORE WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972294067",
            "telephone_number": "866-776-5907",
            "fax_number": "888-443-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEOGENOMICS LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "BISOGNO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "239-768-0600"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "38D2149368",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.