NPIMap

Organization Active NPI

Bakotic Pathology Associates, LLC

  • Clinical Medical Laboratory
  • Tampa, FL
National Provider Identifier
1629781752
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
BAKOTIC PATHOLOGY ASSOCIATES, LLC
Practice address
10770 N 46TH St Ste F200
Tampa, FL 33617-3468
Phone
(855) 422-5628
Fax
(205) 579-9387
NPI assigned
Jan 4, 2023
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Scott Bakotic
Title
Cfo
Phone
(678) 965-2822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

10770 N 46TH St Ste F200
Tampa, FL 33617-3468

Mailing address

6240 Shiloh Rd
Alpharetta, GA 30005-8347
Phone (855) 422-5628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230313000234 FL Part B Supplier - Independent Clinical Laboratory 9436218617 Practice locations: Tampa, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Bakotic Pathology Assoc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2001 Westside Pkwy
Ste 290
Alpharetta, GA 30004
Phone (229) 200-4035

6240 Shiloh Rd
Alpharetta, GA 30005
Phone (855) 245-2256

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1629781752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 SHILOH RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300058347",
            "telephone_number": "855-422-5628",
            "fax_number": "205-579-9387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10770 N 46TH ST STE F200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336173468",
            "telephone_number": "855-422-5628",
            "fax_number": "205-579-9387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAKOTIC PATHOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "BAKOTIC",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-965-2822"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.