NPIMap

Organization Active NPI

Associated Pathology Medical Group

  • Clinical Medical Laboratory
  • Watsonville, CA
National Provider Identifier
1841365129
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
ASSOCIATED PATHOLOGY MEDICAL GROUP
Practice address
75 Neilson St
Watsonville, CA 95076-2468
Phone
(408) 884-2710
Fax
(408) 884-2734
NPI assigned
Nov 21, 2006
Organization subpart
Yes
Parent organization
ASSOCIATED PATHOLOGY MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Authorized official

Name
Liz Sandoval
Title
Billing Manager
Phone
(408) 884-2710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

75 Neilson St
Watsonville, CA 95076-2468

Mailing address

PO Box 665
Los Gatos, CA 95031-0665
Phone (408) 884-2710

Other identifiers 1

IdentifierTypeStateIssuer
GR0088851MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518001205 CA Part B Supplier - Clinic/Group Practice 0143261214 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Los Gatos, CA; Santa Cruz, CA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
Assoc Pathology Med GRP

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1841365129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 665",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950310665",
            "telephone_number": "408-884-2710",
            "fax_number": "408-884-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEILSON ST",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950762468",
            "telephone_number": "408-884-2710",
            "fax_number": "408-884-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED PATHOLOGY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASSOCIATED PATHOLOGY MEDICAL GROUP, INC",
        "enumeration_date": "2006-11-21",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "SANDOVAL",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "408-884-2710"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0088851",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watsonville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.