NPIMap

Organization Active NPI

Princeton Pathology Services PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Newark, NJ
National Provider Identifier
1942498985
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PRINCETON PATHOLOGY SERVICES PA
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(407) 422-9831
Fax
(302) 416-6097
NPI assigned
Oct 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Dr. Mario Gonzalez, MDNPI 1952414476
Title
Owner/President
Phone
(813) 490-7206

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

PO Box 144333
Orlando, FL 32814-4333
Phone (407) 422-9831

Other practice location 1

901 W Main St
Freehold, NJ 07728-2537
Phone (813) 490-7206

Other practice location 2

268 Martin Luther King Jr Blvd
Newark, NJ 07102-2011
Phone (973) 877-5200

Other practice location 3

25 Pocono Rd
Denville, NJ 07834-2954
Phone (813) 490-7206

Other practice location 4

350 Boulevard
Passaic, NJ 07055-2840
Phone (813) 490-7206

Other identifiers 1

IdentifierTypeStateIssuer
0083151MedicaidNJ

Other names 1

  • PRINCETON PATHOLOGY SERVICES PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051020000084 NJ Part B Supplier - Clinic/Group Practice 3779509641 Receives reassigned benefits from 20 practitioners
Practice locations: Passaic, NJ; Newark, NJ; Hamilton, NJ; Freehold, NJ; Montclair, NJ; Denville, NJ

National Provider Directory

National Provider Directory
Tax ID family
Mario Gonzalez MD2 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

7083 Grand National Dr
Ste 102
Orlando, FL 32819

20 Nassau St
Ste 216
Princeton, NJ 08542

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1942498985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "407-422-9831",
            "fax_number": "302-416-6097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 W Main St",
            "address_purpose": "LOCATION",
            "city": "Freehold",
            "state": "NJ",
            "postal_code": "077282537",
            "country_code": "US",
            "telephone_number": "813-490-7206",
            "fax_number": "813-886-6655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "268 Martin Luther King Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071022011",
            "country_code": "US",
            "telephone_number": "973-877-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Pocono Rd",
            "address_purpose": "LOCATION",
            "city": "Denville",
            "state": "NJ",
            "postal_code": "078342954",
            "country_code": "US",
            "telephone_number": "813-490-7206",
            "fax_number": "813-886-6655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Boulevard",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070552840",
            "country_code": "US",
            "telephone_number": "813-490-7206",
            "fax_number": "813-886-6655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRINCETON PATHOLOGY SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-490-7206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0083151",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRINCETON PATHOLOGY SERVICES PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.