NPIMap

Individual provider Active NPI

Marite Campos, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Modesto, CA
National Provider Identifier
1366626509
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A100688 Issued in CA
Practice address
4301 N Star Way
Modesto, CA 95356-9262
Phone
(209) 577-1200
Fax
(209) 577-1200
NPI assigned
Dec 24, 2007
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 243873 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA08620500 NJ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 78877 GA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD459190 PA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A100688 CA Primary

Addresses

Primary practice location

4301 N Star Way
Modesto, CA 95356-9262

Mailing address

4301 N Star Way
Modesto, CA 95356-9262
Phone (209) 577-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC, CA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180613002462 GA Practitioner - Pathology 8729264973 Reassigns benefits to 2 organizations
I20220809000849 NC Practitioner - Pathology 8729264973 Reassigns benefits to 2 organizations
I20241209001842 CA Practitioner - Pathology 8729264973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Regional Laboratories Pathology Services, LLCGroup PAC ID 9133244346, 132 clinicians
Yosemite Pathology Medical Group IncGroup PAC ID 3072415751, 45 clinicians

Practice addresses (Care Compare)

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-6544

4301 N Star Way
Suite a
Modesto, CA 95356-9262
Phone (209) 577-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A100688CAMDAnatomic Pathology & Clinical Pathology Physician
78877GAMDAnatomic Pathology & Clinical Pathology Physician
25MA08620500NJMDAnatomic Pathology & Clinical Pathology Physician
243873NYMDAnatomic Pathology & Clinical Pathology Physician
MD459190PAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Pathology Group, PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2022 Accepting new patients
Dekalb Pathology PC Anatomic Pathology & Clinical Pathology CurrentSince Jun 14, 2021 Accepting new patients
App-Ecp, LLC CurrentSince Jul 1, 2022 Accepting new patients
Yosemite Pathology Medical Group, Inc Anatomic Pathology & Clinical Pathology CurrentSince Jan 2, 2025 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients
Surgical Pathology Associates, LLC Past Accepting new patients
Southwestern Pathology Associates, PC Past Accepting new patients

Locations

520 W I St
Los Banos, CA 93635
Phone (209) 724-0316

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

1390 E Yosemite Ave
Ste B
Merced, CA 95340
Phone (209) 580-3400

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

4301 N Star Way
Modesto, CA 95356
Phone (915) 521-2290

4301 N Star Way
Ste A
Modesto, CA 95356

6100 Waterford District Dr
Ste 450
Miami, FL 33126

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

2693 Forest Hills Rd SW
Ste B
Wilson, NC 27893
Phone (252) 234-2841

5700 Southwyck Blvd
Toledo, OH 43614

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1366626509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N STAR WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569262",
            "telephone_number": "209-577-1200",
            "fax_number": "209-577-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "MARITE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "243873",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA08620500",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "78877",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "PA",
            "license": "MD459190",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A100688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.