Active NPI
Aptive Diagnostics LLC
- Clinical Medical Laboratory
- Houston, TX
National Provider Identifier
1932867355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- APTIVE DIAGNOSTICS LLC
- Practice address
- 11811 North Fwy Ste 416
Houston, TX 77060-3266 - Phone
- (346) 466-8700
- Fax
- (346) 466-8701
- NPI assigned
- Dec 2, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jacob Pollak
- Title
- President
- Phone
- (346) 466-8700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
11811 North Fwy Ste 416
Houston, TX 77060-3266
Mailing address
3920 N 29TH Ave
Hollywood, FL 33020-1010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220729002682 | TX | Part B Supplier - Independent Clinical Laboratory | 8729465430 | Practice locations: Houston, TX |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Aptive Diagnostics LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Forest Park, GA
- NPI 1306521489
-
- Clinical Medical Laboratory
- Hollywood, FL
- NPI 1730835786
Locations
3920 N 29th Ave
Hollywood, FL 33020
Phone (346) 566-8700
65 Jay St
Newark, NJ 07103
Phone (973) 447-8882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638403200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684886400000",
"number": "1932867355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 N 29TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330201010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11811 NORTH FWY STE 416",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770603266",
"telephone_number": "346-466-8700",
"fax_number": "346-466-8701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "APTIVE DIAGNOSTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-12-02",
"last_updated": "2023-05-24",
"certification_date": "2023-05-24",
"status": "A",
"authorized_official_last_name": "POLLAK",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "346-466-8700",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.