NPIMap

Organization Active NPI

Adg Houston Path PLLC

Doing business as ADG Houston Path Lab

  • Clinical Medical Laboratory
  • Houston, TX
National Provider Identifier
1609592450
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ADG HOUSTON PATH PLLC
Doing business as
ADG Houston Path Lab
Practice address
2525 W Bellfort Ave Ste 194
Houston, TX 77054-5099
Phone
(346) 231-1151
Fax
(281) 661-7569
NPI assigned
Oct 13, 2022
Last updated
Oct 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Authorized official

Name
Jaryd Stein, MDNPI 1831304161
Title
President
Phone
(213) 392-4976

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 Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2525 W Bellfort Ave Ste 194
Houston, TX 77054-5099

Mailing address

2525 W Bellfort Ave Ste 194
Houston, TX 77054-5099
Phone (346) 231-1151

Other names 1

  • ADG Houston Path Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230216000005 TX Part B Supplier - Independent Clinical Laboratory 6901283621 Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2080454Adg Houston Path PLLC2525 W Bellfort Ave, Ste 194, Houston, TX 77054ComplianceApr 7, 2028
45D2331762Adg Houston Path PLLC2525 W Bellfort Avenue, Suite 200a, Houston, TX 77054RegistrationOct 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Adg Houston Path2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2525 W Bellfort Ave
Ste 200A
Houston, TX 77054
Phone (281) 661-1573

Practitioners & affiliated clinicians

Practitioners 11

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": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1609592450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 194",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545099",
            "telephone_number": "346-231-1151",
            "fax_number": "281-661-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W BELLFORT AVE STE 194",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770545099",
            "telephone_number": "346-231-1151",
            "fax_number": "281-661-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADG HOUSTON PATH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "JARYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-392-4976",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADG Houston Path Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.