Mardini Pathology, LTD

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

29D0966835 Issued in NV

Legal business name

MARDINI PATHOLOGY, LTD

Doing business as

Great Basin Pathology

Practice address

1250 Lamoille Hwy
Elko, NV 89801-4396

Phone

(775) 753-5845

NPI assigned

Mar 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. George Mardini, MDNPI 1073574828

Title

President

Phone

(775) 753-5845

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Great Basin Pathology Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George Mardini, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Elko, NV
  • NPI 1073574828
  NPD (past) Authorized official

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218067200000",
    "number": "1508827924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 LAMOILLE HWY",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898014396",
            "telephone_number": "775-753-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 LAMOILLE HWY",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898014396",
            "telephone_number": "775-753-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARDINI PATHOLOGY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2008-08-07",
        "status": "A",
        "authorized_official_last_name": "MARDINI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "775-753-5845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NV",
            "license": "29D0966835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002004030",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Basin Pathology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maple Star Nevada
• Maple Star Nevada
• Maple Star Nevada
• Maple Star Nevada
• Margaret Marcucci
• George Mardini, MD
• Gloria Marin
• Rose Lyne Marin
• Marlene Marion
• Jessica Nicole Marks, MFT

• Clinical Medical Laboratory in Elko, NV
• Providers in Elko, NV by specialty
• Clinical Medical Laboratory in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.