NPIMap

Organization Active NPI

Clearwater Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Clearwater, FL
National Provider Identifier
1629138250
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
CLEARWATER PATHOLOGY ASSOCIATES
Practice address
300 Pinellas St
Ms-32
Clearwater, FL 33756-3804
Phone
(727) 462-7062
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Authorized official

Name
George D Schaefer, M.D.NPI 1902967615
Title
President
Phone
(727) 462-7062

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 MULTIPLE SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

300 Pinellas St
Ms-32
Clearwater, FL 33756-3804

Mailing address

PO Box 100561
Atlanta, GA 30384-0561
Phone (727) 462-7062

Other identifiers 1

IdentifierTypeStateIssuer
159444000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050902000601 FL Part B Supplier - Clinic/Group Practice 9931131513 Receives reassigned benefits from 11 practitioners
Practice locations: Clearwater, FL

National Provider Directory

National Provider Directory

Locations

300 Pinellas St
#32
Clearwater, FL 33756
Phone (727) 462-7062

Practitioners & affiliated clinicians

Practitioners 11

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299628800000",
    "number": "1629138250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100561",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840561",
            "telephone_number": "727-462-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PINELLAS ST",
            "address_2": "MS-32",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563804",
            "telephone_number": "727-462-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER PATHOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2011-03-09",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-462-7062",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159444000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; 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.