Organization Active NPI

Interpace Diagnostics Corporation

  • Clinical Medical Laboratory
  • Pittsburgh, PA
National Provider Identifier
1609826304
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
39D1024654 Issued in PA
Legal business name
INTERPACE DIAGNOSTICS CORPORATION
Practice address
2515 Liberty Ave
Pittsburgh, PA 15222-4613
Phone
(412) 224-6100
Fax
(412) 224-6110
NPI assigned
May 11, 2006
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Thomas W Burnell
Title
President and Ceo
Phone
(402) 613-4184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 39D1024654 PA Primary

Addresses

Primary practice location

2515 Liberty Ave
Pittsburgh, PA 15222-4613

Mailing address

2515 Liberty Ave
Pittsburgh, PA 15222-4613
Phone (412) 224-6100

Other identifiers 2

IdentifierTypeStateIssuer
101-855-645-000-1MedicaidPA
001686800OtherPAHIGHMARK BS

Other names 1

  • RedPath Integrated Pathology, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000073 PA Part B Supplier - Independent Clinical Laboratory 4981669777 Practice locations: Pittsburgh, PA

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
39D1024654Interpace Diagnostics Corporation2515 Liberty Avenue, Pittsburgh, PA 15222AccreditationOct 3, 2027

National Provider Directory

National Provider Directory

Locations

2515 Liberty Ave
Pittsburgh, PA 15222
Phone (412) 224-6100

816 Middle St
Fl 2
Pittsburgh, PA 15212
Phone (412) 231-3600

Practitioners & affiliated clinicians

Practitioners 3

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": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1609826304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152224613",
            "telephone_number": "412-224-6100",
            "fax_number": "412-224-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 LIBERTY AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152224613",
            "telephone_number": "412-224-6100",
            "fax_number": "412-224-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERPACE DIAGNOSTICS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "BURNELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "402-613-4184"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PA",
            "license": "39D1024654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101-855-645-000-1",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "001686800",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RedPath Integrated Pathology, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "RedPath Integrated Pathology, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.