Treasure Coast Pathology Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TREASURE COAST PATHOLOGY LAB LLC

Practice address

275 18TH Street
Suite 101
Vero Beach, FL 32960-5541

Phone

(772) 299-5005

Fax

(772) 299-1340

NPI assigned

May 23, 2011

Organization subpart

No

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

Authorized official

Name

Neil S. Medalie, M.D.

Title

Lab Director

Phone

(772) 567-7088

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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

• William J McCormack, M.D., PA

  • Gastroenterology Physician
  • Vero Beach, FL
  • NPI 1922102292
  NPD (past)

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

{
    "created_epoch": "1306108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1760775886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 18TH STREET",
            "address_2": "SUITE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605541",
            "telephone_number": "772-299-5005",
            "fax_number": "772-299-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 18TH STREET",
            "address_2": "SUITE 101",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605541",
            "telephone_number": "772-299-5005",
            "fax_number": "772-299-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST PATHOLOGY LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-23",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "MEDALIE",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "772-567-7088",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treasure Coast Medical Services, Inc.
• Treasure Coast Nurse Practitioners
• Treasure Coast Obstetrics and Gynecology PL
• Treasure Coast Opticians
• Treasure Coast Opticians
• Treasure Coast Pedorthics Inc
• Treasure Coast Prosthetics and Orthotics Services Inc
• Treasure Coast Senior Services, LLC
• Treasure Coast Urology Center, LLC
• Treaure Coast Therapists LLC

• Clinical Medical Laboratory in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.