PACIFIC PATHOLOGY MEDICAL ASSOCIATES – Anatomic Pathology & Clinical Pathology Physician, NPI 1194719740
Anatomic Pathology & Clinical Pathology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for PACIFIC PATHOLOGY MEDICAL ASSOCIATES
5700, Southwyck Boulevard, Southwyck, Toledo, Lucas County, Ohio, 43614, United States
TOLEDO, OH 436141509
Phone: (800) 288-8325
Fax: (419) 866-5453
Type: Mailing
Regional Medical Center of San Jose, 225, North Jackson Avenue, Little Portugal, San Jose, Santa Clara County, California, 95116, United States
SAN JOSE, CA 95116
Phone: (408) 259-5000
Fax: (419) 866-5453
Type: Location
PO BOX 846209
LOS ANGELES, CA 900846209
Phone: (458) 252-9707
Type: Mailing
1322 WHITE OAKS RD
CAMPBELL, CA 950086723
Phone: (458) 252-9707
Fax: (408) 628-4283
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040108001232 | O | Clinic/Group Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43614)
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