NPIMap

Organization Active NPI

Mountain States Pathology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Castle Rock, CO
National Provider Identifier
1669044640
Registry record updated Jul 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
MOUNTAIN STATES PATHOLOGY PC
Practice address
2350 Meadows Blvd
Castle Rock, CO 80109-8405
Phone
(719) 776-5816
NPI assigned
Jul 11, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2021

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

Authorized official

Name
David Newton, MD
Title
President
Phone
(719) 776-5816

Specialties & licenses 1

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

Addresses

Primary practice location

2350 Meadows Blvd
Castle Rock, CO 80109-8405

Mailing address

2222 N Nevada Ave
Colorado Springs, CO 80907-6819
Phone (719) 776-5816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000700 CO Part B Supplier - Clinic/Group Practice 4284616293 Receives reassigned benefits from 18 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Westminster, CO; Pueblo, CO; Longmont, CO; Lakewood, CO; Frisco, CO; Durango, CO; Fort Morgan, CO; Canon City, CO…

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

  • Blair Christian Presti, MD
    • Anatomic Pathology & Clinical Pathology Physician
    • Pueblo, CO
    • NPI 1568426948

    Anatomic Pathology & Clinical Pathology

    NPD
  • Marissa Spino, DO
    • Anatomic Pathology & Clinical Pathology Physician
    • Indianapolis, IN
    • NPI 1295185247

    Anatomic Pathology & Clinical Pathology

    NPD

NPI Registry JSON

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

{
    "created_epoch": "1625961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625961600000",
    "number": "1669044640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 N NEVADA AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076819",
            "telephone_number": "719-776-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 MEADOWS BLVD",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801098405",
            "telephone_number": "719-776-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN STATES PATHOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-11",
        "last_updated": "2021-07-11",
        "certification_date": "2021-07-11",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-776-5816",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2021; 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.