Organization Active NPI

Bayless Pathmark Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Middleburg Heights, OH
National Provider Identifier
1720046865
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
BAYLESS PATHMARK INC
Practice address
19250 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3348
Phone
(440) 826-0384
Fax
(440) 826-1910
NPI assigned
May 1, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Yilan Chang
Title
President
Phone
(440) 826-0384

Other NPIs on the same Medicare enrollment 9

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031210000010 OH Part B Supplier - Clinic/Group Practice 3577469659 Receives reassigned benefits from 9 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alliance, OH; Bellevue, OH; Middleburg Heights, OH; Norwalk, OH

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary

Addresses

NPPES NPI Registry

Primary practice location

19250 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3348

Mailing address

19250 Bagley Rd Ste 101
Middleburg Heights, OH 44130-3348
Phone (440) 826-0384

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
2147788MedicaidOH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 30, 2019.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1720046865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19250 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303348",
            "telephone_number": "440-826-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19250 BAGLEY RD STE 101",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303348",
            "telephone_number": "440-826-0384",
            "fax_number": "440-826-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYLESS PATHMARK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-01-30",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "YILAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-826-0384"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2147788",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.