Active NPI
Pathlink of Georgia LLC
- Anatomic Pathology & Clinical Pathology Physician
- Riverdale, GA
National Provider Identifier
1831890169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- Legal business name
- PATHLINK OF GEORGIA LLC
- Practice address
- 11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615 - Phone
- (770) 991-8000
- NPI assigned
- Mar 14, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mario Gonzalez, MD
- Title
- President
- Phone
- (770) 991-8000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | Primary |
Addresses
Primary practice location
11 Upper Riverdale Rd SW
Riverdale, GA 30274-2615
Mailing address
PO Box 144333
Orlando, FL 32814-4333
Phone (407) 422-9831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230505001460 | GA | Part B Supplier - Clinic/Group Practice | 8527423094 |
Receives reassigned benefits from 2 practitioners Practice locations: Riverdale, GA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Riverdale, GA
- NPI 1811286446
Anatomic Pathology & Clinical Pathology, GA
-
- Anatomic Pathology & Clinical Pathology Physician
- Griffin, GA
- NPI 1780647412
Anatomic Pathology & Clinical Pathology, GA
-
- Interventional Cardiology Physician
- Riverdale, GA
- NPI 1477500734
-
- Interventional Cardiology Physician
- Riverdale, GA
- NPI 1659334829
-
- Neurology Physician
- Stockbridge, GA
- NPI 1184696973
-
- Neurology Physician
- Fayetteville, GA
- NPI 1689602385
-
- Emergency Medical Services (Emergency Medicine) Physician
- Riverdale, GA
- NPI 1740388172
-
- Cardiovascular Disease Physician
- Riverdale, GA
- NPI 1043219256
-
- Cardiovascular Disease Physician
- Riverdale, GA
- NPI 1659334209
-
- Cardiovascular Disease Physician
- McDonough, GA
- NPI 1023054806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678752000000",
"number": "1831890169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 144333",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328144333",
"telephone_number": "407-422-9831",
"fax_number": "407-648-2065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 UPPER RIVERDALE RD SW",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302742615",
"telephone_number": "770-991-8000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PATHLINK OF GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-14",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A",
"authorized_official_last_name": "GONZALEZ",
"authorized_official_first_name": "MARIO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "770-991-8000",
"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 Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.