NPIMap

Organization Active NPI

Pathology Associates of Anaheim a Professional Medical Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Anaheim, CA
National Provider Identifier
1861535718
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
G50440 Issued in CA
Legal business name
PATHOLOGY ASSOCIATES OF ANAHEIM A PROFESSIONAL MEDICAL CORPORATION
Practice address
1111 W la Palma Ave
Ammc - Dept. of Pathology
Anaheim, CA 92801-2804
Phone
(714) 999-6075
Fax
(714) 999-3822
NPI assigned
Feb 14, 2007
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Dr. Terry Welsh, M.D.NPI 1700881786
Title
President
Phone
(714) 719-2148

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G50440 CA Primary

Addresses

Primary practice location

1111 W la Palma Ave
Ammc - Dept. of Pathology
Anaheim, CA 92801-2804

Mailing address

1111 W la Palma Ave
Anaheim, CA 92801-2804
Phone (714) 999-6075

Other identifiers 2

IdentifierTypeStateIssuer
GR0104860MedicaidCA
ZZZ69658ZOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000494 CA Part B Supplier - Clinic/Group Practice 6709983497 Receives reassigned benefits from 4 practitioners
Practice locations: Anaheim, CA; Riverside, CA; Whittier, CA

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1861535718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W LA PALMA AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012804",
            "telephone_number": "714-999-6075",
            "fax_number": "714-999-3822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W LA PALMA AVE",
            "address_2": "AMMC - DEPT. OF PATHOLOGY",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012804",
            "telephone_number": "714-999-6075",
            "fax_number": "714-999-3822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF ANAHEIM A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "WELSH",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-719-2148",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G50440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104860",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ69658Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.