Organization Active NPI

Cutaneous Pathology, P.a.

  • Dermatopathology (Pathology) Physician
  • Winston Salem, NC
National Provider Identifier
1881841856
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
138498 Issued in NC
Legal business name
CUTANEOUS PATHOLOGY, P.A.
Practice address
1800 S Hawthorne Rd Ste 200
Winston Salem, NC 27103-4014
Phone
(336) 760-1388
Fax
(336) 760-1398
NPI assigned
Aug 21, 2008
Last updated
Dec 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Dr. Omar Pastor Sangueza, MDNPI 1770569436
Title
President
Phone
(336) 760-1388

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
Dermatopathology (Pathology) Physician 207ZD0900X 138498 NC Primary

Addresses

Primary practice location

1800 S Hawthorne Rd Ste 200
Winston Salem, NC 27103-4014

Mailing address

PO Box 306648
Nashville, TN 37230-6648
Phone (336) 760-1388

Other identifiers 2

IdentifierTypeStateIssuer
QPB748MedicaidSC
5950703MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090128000060 NC Part B Supplier - Clinic/Group Practice 0446314918 Receives reassigned benefits from 2 practitioners
Practice locations: Winston Salem, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D1087769Cutaneous Pathology1800 S Hawthorne Road, Suite 200, Winston Salem, NC 27103AccreditationSep 15, 2027

National Provider Directory

National Provider Directory

Locations

1900 S Hawthorne Rd
Ste 366
Winston Salem, NC 27103
Phone (336) 760-1388

Practitioners & affiliated clinicians

Practitioners 2

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": "1219276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1881841856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306648",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306648",
            "telephone_number": "336-760-1388",
            "fax_number": "336-760-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 S HAWTHORNE RD STE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034014",
            "telephone_number": "336-760-1388",
            "fax_number": "336-760-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUTANEOUS PATHOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-21",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "SANGUEZA",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "PASTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-760-1388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NC",
            "license": "138498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "QPB748",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950703",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.