NPIMap

Organization Active NPI

Bayless Pathmark Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Cleveland, OH
National Provider Identifier
1629267232
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
BAYLESS PATHMARK INC
Practice address
Southwest General Health Center
18697 Bagley Road, Laboratory Services
Cleveland, OH 44130
Phone
(440) 826-0384
Fax
(440) 826-1910
NPI assigned
Oct 19, 2007
Organization subpart
Yes
Parent organization
BAYLESS PATHMARK INCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Dr. Yilan ChangNPI 1295711992
Title
President
Phone
(440) 826-0384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 7

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

  • Yilan L Chang, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Norwalk, OH
    • NPI 1295711992

    Anatomic Pathology & Clinical Pathology

    NPD Authorized official
  • Robert H Crabtree, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Brecksville, OH
    • NPI 1326006875

    Anatomic Pathology & Clinical Pathology

    NPD
  • Ana Tereza Andrade Kabira, M.D.
    • Anatomic Pathology & Clinical Pathology Physician
    • Middleburg Heights, OH
    • NPI 1578852000

    Anatomic Pathology & Clinical Pathology

    NPD
  • Zejin Jason Liu, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Brecksville, OH
    • NPI 1073571527

    Anatomic Pathology & Clinical Pathology

    NPD
  • Martin Z Rabinowitz, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Middleburg Heights, OH
    • NPI 1972561421

    Anatomic Pathology & Clinical Pathology

    NPD
  • Yuchu Sun, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Middleburg Heights, OH
    • NPI 1568922029

    Anatomic Pathology & Clinical Pathology

    NPD
  • Sadia Sultana, M.D.
    • Anatomic Pathology & Clinical Pathology Physician
    • Houston, TX
    • NPI 1093151557

    Anatomic Pathology & Clinical Pathology

    NPD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000010 OH Part B Supplier - Clinic/Group Practice 3577469659 Receives reassigned benefits from 9 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alliance, OH; Bellevue, OH; Middleburg Heights, OH; Norwalk, OH

National Provider Directory

National Provider Directory
Tax ID family
Pathmark Inc Hillcrest4 organizations share this tax ID, including this one
Part of
Pathmark Inc Hillcrest

Other organizations with this tax ID 3

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

NPPES NPI Registry

Primary practice location

Southwest General Health Center
18697 Bagley Road, Laboratory Services
Cleveland, OH 44130

Mailing address

19250 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3348
Phone (440) 826-0384

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
=========OtherOHBWC
=========OtherOHTRICARE
0119535MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2020.

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1629267232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19250 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303348",
            "telephone_number": "440-826-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTHWEST GENERAL HEALTH CENTER",
            "address_2": "18697 BAGLEY ROAD, LABORATORY SERVICES",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44130",
            "telephone_number": "440-826-0384",
            "fax_number": "440-826-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLESS PATHMARK INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAYLESS PATHMARK INC",
        "enumeration_date": "2007-10-19",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "YILAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-826-0384",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "=========",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "=========",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119535",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.