NPIMap

Organization Active NPI

Physicians Laboratory, LTD.

  • Anatomic Pathology & Clinical Pathology Physician
  • Sioux Falls, SD
National Provider Identifier
1891747093
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PHYSICIANS LABORATORY, LTD.
Practice address
1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019
Phone
(605) 322-7200
Fax
(605) 322-7222
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Authorized official

Name
Lee J Brandt
Title
Administrator
Phone
(605) 322-7208

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

1301 S Cliff Ave
Suite 700
Sioux Falls, SD 57105-1019

Mailing address

PO Box 5050
Sioux Falls, SD 57117-5050
Phone (605) 322-7200

Other names 1

  • Physicians Laboratory Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031217000159 SD Part B Supplier - Clinic/Group Practice 9234036310 Receives reassigned benefits from 16 practitioners
Practice locations: Sioux Falls, SD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Physicians Laboratory2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1315 S Cliff Ave
Ste 4100
Sioux Falls, SD 57105

1301 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-7187

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1891747093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5050",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175050",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CLIFF AVE",
            "address_2": "SUITE 700",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051019",
            "telephone_number": "605-322-7200",
            "fax_number": "605-322-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS LABORATORY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-322-7208"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Physicians Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.