NPIMap

Organization Active NPI

Affiliated Pathologists of the Central Coast

  • Anatomic Pathology & Clinical Pathology Physician
  • Arroyo Grande, CA
National Provider Identifier
1942540497
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
05D0586961 Issued in CA
Legal business name
AFFILIATED PATHOLOGISTS OF THE CENTRAL COAST
Practice address
345 S Halcyon Rd
Arroyo Grande, CA 93420-3817
Phone
(805) 489-4261
NPI assigned
Feb 20, 2013
Last updated
Jun 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Authorized official

Name
Wendy Antonio
Title
Bookkeeper
Phone
(805) 710-7308

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 05D0586961 CA Primary

Addresses

Primary practice location

345 S Halcyon Rd
Arroyo Grande, CA 93420-3817

Mailing address

PO Box 5007
San Luis Obispo, CA 93403-5007
Phone (805) 710-7308

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130423000104 CA Part B Supplier - Clinic/Group Practice 9436395266 Receives reassigned benefits from 3 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Luis Obispo, CA; Templeton, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Affiliated Pathologists of the Central Coast5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1361318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1942540497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5007",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934035007",
            "telephone_number": "805-710-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 S HALCYON RD",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203817",
            "telephone_number": "805-489-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFILIATED PATHOLOGISTS OF THE CENTRAL COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "ANTONIO",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "805-710-7308"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "05D0586961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.