Medusa Pathology Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDUSA PATHOLOGY INC

Practice address

529 Soscol Ave
Napa, CA 94559-3405

Phone

(707) 307-3151

NPI assigned

Mar 18, 2021

Organization subpart

No

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

Authorized official

Name

Brady FelizNPI 1902868714

Title

MD

Phone

(800) 288-8325

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Tax ID family

Medusa Pathology Inc2 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.

• Medusa Pathology Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Napa, CA
  • NPI 1912510520
  NPD tax ID

Locations

Practitioners 2

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

• Brady J Feliz, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Napa, CA
  • NPI 1902868714
  NPD (past) Authorized official
• Charles C Young, MD

  • Diplomate Laboratory Management Specialist/Technologist
  • Napa, CA
  • NPI 1669120564
  NPD

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1629654900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SOSCOL AVE",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945593405",
            "telephone_number": "707-307-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDUSA PATHOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "FELIZ",
        "authorized_official_first_name": "BRADY",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "800-288-8325"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey Medina
• Jennifer Loren Medina
• Riann Medina
• Zack I Medoff, PHD
• Alonso Medrano
• Medusa Pathology Inc
• Mariam Meeran
• Meher Lifestyle and Wellness Corp
• Meher Lifestyle and Wellness Corp
• Ryan Mehlhaff

• Clinical Medical Laboratory in Napa, CA
• Providers in Napa, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.