NPIMap

Organization Active NPI

Main Line Pathology Associates, PC

  • Clinical Pathology/Laboratory Medicine Physician
  • Bryn Mawr, PA
National Provider Identifier
1548260482
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
MAIN LINE PATHOLOGY ASSOCIATES, PC
Practice address
130 Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone
(484) 337-3356
Fax
(484) 337-4578
NPI assigned
Jul 21, 2005
Last updated
Dec 30, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Walter Klein, MDNPI 1326083833
Title
President
Phone
(484) 337-3556

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
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X PA Primary

Addresses

Primary practice location

130 Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Mailing address

111 Continental Drive
Suite 304
Newark, PA 19713
Phone (888) 625-4685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040723000929 PA Part B Supplier - Clinic/Group Practice 9830179381 Receives reassigned benefits from 11 practitioners
Practice locations: Media, PA; Wynnewood, PA; Paoli, PA; Bryn Mawr, PA

National Provider Directory

National Provider Directory

Locations

111 Continental Dr
Ste 304
Newark, DE 19713

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1548260482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CONTINENTAL DRIVE",
            "address_2": "SUITE 304",
            "city": "NEWARK",
            "state": "PA",
            "postal_code": "19713",
            "telephone_number": "888-625-4685",
            "fax_number": "302-731-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3356",
            "fax_number": "484-337-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE PATHOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-21",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-337-3556",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.