Organization Active NPI

Quantum Pathology, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Waltham, MA
National Provider Identifier
1942601570
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
QUANTUM PATHOLOGY, LLC
Practice address
318 Bear Hill Rd
Waltham, MA 02451-1095
Phone
(781) 373-1689
Fax
(781) 373-2078
NPI assigned
Sep 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Erik Diguilio
Title
Chief Executive Officer
Phone
(781) 373-1689

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

318 Bear Hill Rd
Waltham, MA 02451-1095

Mailing address

318 Bear Hill Rd
Waltham, MA 02451-1095
Phone (781) 373-1689

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141230000850 MA Part B Supplier - Independent Clinical Laboratory 4284957192 Practice locations: Waltham, MA

National Provider Directory

National Provider Directory

Locations

129 Morgan Dr
Ste 204
Norwood, MA 02062
Phone (781) 373-1689

303 Bear Hill Rd
#2
Waltham, MA 02451
Phone (781) 373-1689

318 Bear Hill Rd
Waltham, MA 02451
Phone (781) 373-1689

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1942601570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 BEAR HILL RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511095",
            "telephone_number": "781-373-1689",
            "fax_number": "781-373-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 BEAR HILL RD",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511095",
            "telephone_number": "781-373-1689",
            "fax_number": "781-373-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUANTUM PATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-15",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "DIGUILIO",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "781-373-1689"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; 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.