NPIMap

Organization Active NPI

Pathology Associates of Silver Spring, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Silver Spring, MD
National Provider Identifier
1629016282
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PATHOLOGY ASSOCIATES OF SILVER SPRING, LLC
Practice address
1500 Forest Glen Rd
Silver Spring, MD 20910-1483
Phone
(301) 754-7335
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Pablo Daniel Gutman, MDNPI 1679685887
Title
Owner
Phone
(301) 529-1028

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 & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1500 Forest Glen Rd
Silver Spring, MD 20910-1483

Mailing address

8810 Eggert Dr
Bethesda, MD 20817
Phone (301) 529-1028

Other identifiers 1

IdentifierTypeStateIssuer
143401200MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070209000061 DC Part B Supplier - Clinic/Group Practice 9335141035 Receives reassigned benefits from 12 practitioners
Practice locations: Silver Spring, MD; Germantown, MD

National Provider Directory

National Provider Directory
Tax ID family
Pathology Associates of Silver Spring LLC2 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.

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1629016282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 EGGERT DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20817",
            "telephone_number": "301-529-1028",
            "fax_number": "301-754-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FOREST GLEN RD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101483",
            "telephone_number": "301-754-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF SILVER SPRING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "GUTMAN",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-529-1028",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143401200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.