Organization Active NPI

Atlantic Gastrointestinal Pathology PC

  • Anatomic Pathology Physician
  • Franklin Lakes, NJ
National Provider Identifier
1528829496
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
Legal business name
ATLANTIC GASTROINTESTINAL PATHOLOGY PC
Practice address
700 High Woods Dr
Franklin Lakes, NJ 07417-2255
Phone
(516) 567-5410
NPI assigned
Jan 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Authorized official

Name
Dr. Boris Chusid, MDNPI 1518967769
Title
Owner
Phone
(201) 289-1121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0101X Primary

Addresses

Primary practice location

700 High Woods Dr
Franklin Lakes, NJ 07417-2255

Mailing address

PO Box 86
Jericho, NY 11753-0086

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240712003764 NJ Part B Supplier - Clinic/Group Practice 9335684455 Receives reassigned benefits from 1 practitioner
Practice locations: Franklin Lakes, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1705536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1528829496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86",
            "city": "JERICHO",
            "state": "NY",
            "postal_code": "117530086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH WOODS DR",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074172255",
            "telephone_number": "516-567-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC GASTROINTESTINAL PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-18",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "CHUSID",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-289-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; 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.