Organization Active NPI

Novinopath Diagnostics LLC

  • Clinical Medical Laboratory
  • Bayside, NY
National Provider Identifier
1629655295
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
NOVINOPATH DIAGNOSTICS LLC
Practice address
21410 24TH Ave
Bayside, NY 11360-2219
Phone
(718) 663-2118
Fax
(888) 377-1244
NPI assigned
Mar 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Dr. Josephine Wu, DDSNPI 1205905593
Title
Authorized Official/General Manager
Phone
(718) 213-6274

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
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

21410 24TH Ave
Bayside, NY 11360-2219

Mailing address

6143 186TH St
Fresh Meadows, NY 11365-2710
Phone (718) 213-6274

Other practice location 1

2619 Francis Lewis Blvd
Flushing, NY 11358-1161
Phone (718) 213-6274

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210803003754 NY Part B Supplier - Independent Clinical Laboratory 7719381383 Practice locations: Bayside, NY; Flushing, NY

National Provider Directory

National Provider Directory

Locations

2619 Francis Lewis Blvd
#L22
Flushing, NY 11358
Phone (718) 213-6274

Practitioners & affiliated clinicians

Practitioners 1

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": "1616889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1629655295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "718-213-6274",
            "fax_number": "888-377-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21410 24TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602219",
            "telephone_number": "718-663-2118",
            "fax_number": "888-377-1244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2619 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113581161",
            "country_code": "US",
            "telephone_number": "718-213-6274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NOVINOPATH DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-28",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/GENERAL MANAGER",
        "authorized_official_telephone_number": "718-213-6274",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.