NPIMap

Organization Active NPI

Gateway Pathology Assoc

  • Clinical Pathology/Laboratory Medicine Physician
  • Clinton, IA
National Provider Identifier
1457407124
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
21940 Issued in IA
Legal business name
GATEWAY PATHOLOGY ASSOC
Practice address
1410 N 4TH Street
Clinton, IA 52732
Phone
(563) 242-5316
Fax
(563) 242-3128
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Elpidio G Mariano, MDNPI 1740260645
Title
Managing Partner
Phone
(563) 242-5316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0105X 21940 IA Primary

Addresses

Primary practice location

1410 N 4TH Street
Clinton, IA 52732

Mailing address

PO Box 0361
Clinton, IA 52733-0361
Phone (563) 242-5316

Other identifiers 3

IdentifierTypeStateIssuer
31964OtherIABC BS
0477950MedicaidIA
DC6462OtherRR MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1457407124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0361",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527330361",
            "telephone_number": "563-242-5316",
            "fax_number": "563-242-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 N 4TH STREET",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "52732",
            "telephone_number": "563-242-5316",
            "fax_number": "563-242-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PATHOLOGY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "MARIANO",
        "authorized_official_first_name": "ELPIDIO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "563-242-5316",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IA",
            "license": "21940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "31964",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0477950",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DC6462",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.