MATTISON PATHOLOGY, L.L.P.
NPI 1063619922
Pathology - Anatomic Pathology & Clinical Pathology in Dallas, TX

NPI Status: Active since July 02, 2007

Contact Information

4245 N CENTRAL EXPY STE 420
DALLAS, TX
ZIP 75205
Phone: (866) 987-7284
Fax: (469) 232-9927

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  • Organization
  • Pathology
  • Anatomic Pathology & Clinical Pathology
  • Accepts Insurance
  • CLIA Number: 45D1015603
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 05-08-2027

About MATTISON PATHOLOGY, L.L.P.

This page provides the complete NPI Profile along with additional information for Mattison Pathology, L.l.p., a provider established in Dallas, Texas operating as a Pathology, focusing in anatomic pathology & clinical pathology . The healthcare provider is registered in the NPI registry with number 1063619922 assigned on July 2007. The practitioner's primary taxonomy code is 207ZP0102X. The provider is registered as an organization and their NPI record was last updated one year ago. Mattison Pathology, L.l.p. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's . The authorized official of this NPI record is Dr. Gregory M Wolgamot M.d., Ph.d. (Medical Director)

NPI
1063619922
Provider Legal Name
MATTISON PATHOLOGY, L.L.P.
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4245 N CENTRAL EXPY STE 420 DALLAS, TX 75205
Location Phone
(866) 987-7284
Location Fax
(469) 232-9927
Mailing Address
3560 MERIDIAN ST STE 101 BELLINGHAM, WA 98225
Mailing Phone
(360) 734-2800
Mailing Fax
(469) 232-9927
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-02-2007
Last Update Date
12-15-2025
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Location Map

Secondary Locations

  • 4642 N Loop 289 Ste 205
    Lubbock, TX 79416
    (866) 987-7284

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pathology Anatomic Pathology & Clinical Pathology

Taxonomy Code
207ZP0102X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207ZC0500XAllopathic & Osteopathic Physicians

Pathology
Cytopathology

 
2291U00000XLaboratories

Clinical Medical Laboratory

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Standard Silver + Vision + Adult Dental - PPO
  • MENDING Direct Primary Care Bronze 4950 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Gold $0 Ded ($0 DPC $0 PCP + $0 Mental Health) - HMO
  • MENDING Direct Primary Care Silver 2300 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
  • MENDING Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
  • MENDING Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
  • MENDING Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Saver 750 - HMO
  • Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
  • Molina Gold Saver 750 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver with Four Free PCP Visits - HMO
  • Molina Silver Standard - HMO
  • Wellpoint Essential Bronze 4000 HSA (+ Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
  • Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Catastrophic (+ Incentives) - HMO
  • Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. GREGORY M WOLGAMOT M.D., PH.D.

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(866) 987-7284

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
45D1065927OTHER (01)TXCLIA
7187034OTHER (01)TXCOLLEGE OF AMERICAN PATHOLOGISTS
45D1015603OTHER (01)TXCLIA
7201511OTHER (01)TXCOLLEGE OF AMERICAN PATHOLOGISTS
00Z224OTHER (01)MEDICARE PTAN
45D1069527OTHER (01)TXCLIA #

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D1015603
Facility Type
Independent
Certificate Effective Date
May 09, 2025
Certificate Expiration Date
May 08, 2027
Laboratory Director
DR. RODNEY W. STUART
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Mattison Pathology, L.l.p. after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1063619922, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
1
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
9
Unchanged
Pos 9
2
Doubled → 4
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 9 → 18 → 9 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 2 + 3 + 1 + 2 + 1 + 1 + 8 + 9 + 4 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1063619922.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinical Medical Laboratory
4245 N CENTRAL EXPY STE 420
DALLAS, TX 75205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1063619922, enumerated as an "organization" on July 02, 2007.

The provider is located at 4245 N CENTRAL EXPY STE 420 DALLAS, TX 75205 and the phone number is (866) 987-7284.

Pathology with taxonomy code 207ZP0102X and a focus in Anatomic Pathology & Clinical Pathology.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.