ASSOCIATED PATHOLOGY MEDICAL GROUP, INC (NPI# 1679659114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679659114 |
| Entity Type | Organization |
| Organization Name | ASSOCIATED PATHOLOGY MEDICAL GROUP, INC |
| Practice Address |
1555 Soquel Dr Santa Cruz CA 95065-1705 |
| Mailing Address |
Po Box 665 Los Gatos CA 95031-0665 |
| Practice Telephone | 4088842710 |
| Practice Fax Number | 4088842734 |
| Mailing Telephone | 4088842710 |
| Mailing Fax Number | 4088842734 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | ELIZABETH ANN SANDOVAL (BILLING MANAGER) |
| Authorized Official Telephone | 4088842710 |
| Is Organization Subpart | Y |
| Parent Organization Name | ASSOCIATED PATHOLOGY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 05D0606603 | CA | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SAN FRANCISCO HEALTH PLAN | Q682 | 01 |
| CA | GR0088851 | 05 | |
| CA | MEDICARE RAILROAD | CS1327 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932283264 | Associated Pathology Medical Group, Inc | Specialist | 105a Cooper Ct, Los Gatos, CA 95032-7604 | 2006-10-24 |
| Street Address |
1555 SOQUEL DR |
| City | SANTA CRUZ |
| State | CA |
| Zip Code | 95065-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073583811 | Kathleen Dempsey | Nurse Practitioner | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2006-01-24 |
| 1073148235 | James Douglas Bergum | Perfusionist | 1555 Soquel Dr, Santa Cruz, CA 95065-1794 | 2020-03-09 |
| 1790335636 | Melissa L Herceg | Social Worker | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2019-09-12 |
| 1720633597 | Bonny Masters Md Inc | Physical Medicine & Rehabilitation | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2019-08-07 |
| 1851869606 | Brian Nalley | Pharmacist | 1555 Soquel Dr, Santa Cruz, CA 95065-1794 | 2018-11-09 |
| 1619401460 | Emily P Otto | Registered Nurse | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2017-04-19 |
| 1104289040 | Brook Goddard | Emergency Medicine | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2016-03-29 |
| 1750754776 | Lora Boone | Physical Medicine & Rehabilitation | 1555 Soquel Dr, Dominican Hospital, Santa Cruz, CA 95065 | 2015-11-13 |
| 1427433408 | Terrie M Uzunangelov | Speech-Language Pathologist | 1555 Soquel Dr, Santa Cruz, CA 95065 | 2015-07-20 |
| 1649662131 | David Goldman | Anesthesiology | 1555 Soquel Dr, Santa Cruz, CA 95065-1705 | 2015-02-20 |
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|---|---|---|---|---|
| 1295335743 | Mindful Living Psychotherapy | Clinic/Center | 24340 Ca-78, Ramona, CA 95065 | 2020-10-26 |
| 1265084297 | Care From The Heart In Home Services, Inc. | In Home Supportive Care | 3141 Paul Sweet Road, Santa Cruz, CA 95065 | 2019-07-10 |
| 1215410188 | Barry Lynn Keeler | Pharmacist | Dominican Plaza Pharmacy, 1595 Soquel Dr Suite 120, Santa Cruz, CA 95065 | 2018-09-07 |
| 1407212582 | Naikan Counseling Center | Community/Behavioral Health | 3319b Mission Drive, Santa Cruz, CA 95065 | 2016-01-05 |
| 1124461587 | Lindsay Mooney | Obstetrics & Gynecology | 2907 Chanticleer Ave Fl 2, Santa Cruz, CA 95065 | 2013-04-16 |
| 1689911398 | Gabriela Alejandra Torres De Fernandez | Dentist | 1588 Soquel Dr Suite 3, Santa Cruz, CA 95065 | 2013-01-15 |
| 1184999211 | Shannon Leigh Purpuri | Midwife | 401 Happy Valley Rd, Santa Cruz, CA 95065 | 2012-03-22 |
| 1619119997 | Himabindu Pitta | Hospitalist | 1555 Soquel Dr., Santa Cruz, CA 95065 | 2009-04-01 |
| 1780834614 | Rym C Partridge | Dentist | 3337 Mission Dr., Santa Cruz, CA 95065 | 2008-09-29 |
| 1710177159 | Jill Bewley | Acupuncturist | 100 Burton Dr, Santa Cruz, CA 95065 | 2007-08-01 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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|---|---|---|---|---|
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| City | SANTA CRUZ |
| Zip Code | 95065 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.