Individual provider Active NPI

Michael A Friedberg

  • Anatomic Pathology & Clinical Pathology Physician
  • San Antonio, TX
National Provider Identifier
1861481608
Registry record updated Jul 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
K4427 Issued in TX
Practice address
333 N Santa Rosa Ave
Path Dept
San Antonio, TX 78207-3108
Phone
(210) 735-9461
Fax
(210) 736-3835
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X K4427 TX Primary

Addresses

Primary practice location

333 N Santa Rosa Ave
Path Dept
San Antonio, TX 78207-3108

Mailing address

2823 Dason Ledge
San Antonio, TX 78258-4637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318001504 NC Practitioner - Pathology 1658358320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ecu Physicians Diagnostic Pathology Services Anatomic Pathology & Clinical Pathology CurrentSince Mar 2, 2020 Accepting new patients
Sierra Laboratory Associates PA Anatomic Pathology & Clinical Pathology Past Accepting new patients
Pathology Associates of San Antonio, L.L.P. Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184976000000",
    "number": "1861481608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 DASON LEDGE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA AVE",
            "address_2": "PATH DEPT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-735-9461",
            "fax_number": "210-736-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDBERG",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "K4427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.