NPIMap

Organization Active NPI

South Suburban Pathologists PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Conyers, GA
National Provider Identifier
1720016801
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
SOUTH SUBURBAN PATHOLOGISTS PC
Practice address
141 Milstead Ave NE
Conyers, GA 30012
Phone
(678) 423-1550
Fax
(678) 423-1550
NPI assigned
Jun 29, 2006
Last updated
Aug 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Authorized official

Name
Dr. Zoya K Arbiser, M.D.NPI 1396776084
Title
President
Phone
(770) 991-8615

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
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

141 Milstead Ave NE
Conyers, GA 30012

Mailing address

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (678) 423-1550

Other practice location 1

11 Upper Riverdale Rd SW
Attn: Pathology
Riverdale, GA 30274-2615
Phone (770) 991-8615

Other identifiers 1

IdentifierTypeStateIssuer
300026912BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000192 GA Part B Supplier - Clinic/Group Practice 0547254872 Receives reassigned benefits from 15 practitioners
Practice locations: Covington, GA; Marietta, GA; Monroe, GA; Conyers, GA

National Provider Directory

National Provider Directory

Locations

2550 Windy Hill Rd SE
Ste 301
Marietta, GA 30067
Phone (770) 739-9555

11 Upper Riverdale Rd SW
#U
Riverdale, GA 30274
Phone (678) 423-1550

3969 S Cobb Dr SE
Ste 100
Smyrna, GA 30080

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1720016801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "678-423-1550",
            "fax_number": "678-423-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "678-423-1550",
            "fax_number": "678-423-1550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Upper Riverdale Rd SW",
            "address_2": "ATTN: PATHOLOGY",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "GA",
            "postal_code": "302742615",
            "country_code": "US",
            "telephone_number": "770-991-8615",
            "fax_number": "770-991-8689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH SUBURBAN PATHOLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "ARBISER",
        "authorized_official_first_name": "ZOYA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-991-8615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300026912B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.