DERMPATH DIAGNOSTICS OF WI
NPI 1164494142
Clinical Medical Laboratory in Brookfield, WI

NPI Status: Active since February 03, 2006

Contact Information

12805 W BURLEIGH RD
SUITE 200
BROOKFIELD, WI
ZIP 53005
Phone: (262) 797-6434
Fax: (262) 797-6429

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  • Organization
  • Clinical Medical Laboratory
  • Accepts Insurance
  • CLIA Number: 52D0661946
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 02-12-2027

About DERMPATH DIAGNOSTICS OF WI

This page provides the complete NPI Profile along with additional information for Dermpath Diagnostics Of Wi, a provider established in Brookfield, Wisconsin operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1164494142 assigned on February 2006. The practitioner's primary taxonomy code is 291U00000X with license number 52D0661946 (WI). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's other name is Dermpath Diagnostics Of Wi. The authorized official of this NPI record is Darren Thomas Wheeler Md (Vice President)

NPI
1164494142
Provider Legal Name
DERMATOPATHOLOGY OF WISCONSIN SC
Other Organization Name
DERMPATH DIAGNOSTICS OF WI
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
12805 W BURLEIGH RD SUITE 200 BROOKFIELD, WI 53005
Location Phone
(262) 797-6434
Location Fax
(262) 797-6429
Mailing Address
14275 MIDWAY RD STE 400 ADDISON, TX 75001
Mailing Phone
(214) 932-8018
Mailing Fax
(262) 797-6429
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-03-2006
Last Update Date
09-20-2024
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Establishments like Dermpath Diagnostics Of Wi are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

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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

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
License No.
52D0661946
License State
WI
Taxonomy Description
(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.

Insurance Plans Accepted

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

  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - HMO
  • Medica Individual Choice Silver $0 Copay PCP Visits - HMO
  • Medica Individual Choice Silver Share - HMO
  • Medica Individual Choice Silver Standard - HMO
  • Prestige Bronze $0 Medical Deductible - HMO
  • Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
  • Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
  • Prestige Bronze Essential + 3 Free PCP Visits - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
  • MyPriority Balanced Silver - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Value Bronze - HMO
  • MyPriority Value Bronze HSA - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • Sanford Individual Simplicity $1,750 - PPO
  • Sanford Individual Simplicity $10,600 - PPO
  • Sanford Individual Simplicity $3,500 - PPO
  • Sanford Individual Simplicity $4,750 - PPO
  • Sanford Individual Simplicity $6,500 - PPO
  • Sanford Individual Simplicity $7,200 HSA Qualified - PPO
  • Sanford Individual Simplicity Standardized $2,000 - PPO
  • Sanford Individual Simplicity Standardized $6,000 - PPO
  • Sanford Individual Simplicity Standardized $7,500 - PPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus (No Referrals) - HMO
  • UHC Bronze Copay Focus (Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus + (Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO

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

DARREN THOMAS WHEELER MD

Authorized Official Title
VICE PRESIDENT
Authorized Official Phone
(702) 733-7866

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
1164494142MEDICAID (05)MI 
5585170MEDICAID (05)SD 
32911800MEDICAID (05)WI 
0765271MEDICAID (05)IA 
14900MEDICAID (05)ND 
749475100MEDICAID (05)MN 
52D1105706OTHER (01)WICLIA

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Pathology examination of tissue using a microscope, intermediate complexity

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

This service was performed 17,811 times for 10,681 patients

Pathology examination of tissue using a microscope, moderately low complexity

A pathology examination of tissue, moderately low complexity, involves studying a small sample of your body tissue under a microscope. It helps to identify any abnormal cells or diseases. It's a routine procedure, not complex, and provides crucial insights for your diagnosis.

This service was performed 714 times for 614 patients

Special stained specimen slides to examine tissue including interpretation and report

Special stained specimen slides are used to examine tissue samples. This involves applying special dyes to the tissue, which helps to highlight certain features under a microscope. The findings are then interpreted and a report is provided. This can aid in diagnosing various health conditions.

This service was performed 20 times for 14 patients

Special stained specimen slides to examine tissue, each additional procedure

Special stained specimen slides are used to analyze tissue in detail. In this process, extra procedures may be needed for a more thorough examination. These involve applying special stains to the tissue on slides, enhancing specific elements for closer study.

This service was performed 1,151 times for 620 patients

Special stained specimen slides to examine tissue, each multiplex procedure

Special stained specimen slides are used to study tissue in detail. This multiplex procedure involves applying different dyes to the tissue sample on a slide to highlight specific elements. These colors help identify any abnormalities in the tissue, aiding in accurate diagnosis and treatment planning.

This service was performed 18 times for 17 patients

Special stained specimen slides to examine tissue, initial procedure

This procedure involves the use of specially stained slides to examine tissue samples. The initial process involves obtaining a small tissue sample from your body. This sample is then placed on a slide and stained with special dyes to highlight different structures and elements. The stained slide is then examined under a microscope to help diagnose any potential health issues.

This service was performed 913 times for 808 patients

Special stained specimen slides to identify organisms including interpretation and report

This service involves coloring specimen slides in a special way to help identify organisms. The colors make different parts of the organism stand out. Afterward, a detailed interpretation and report on the findings are provided.

This service was performed 505 times for 390 patients

Surgical pathology consultation and report on referred material requiring preparation of slides

A surgical pathology consultation involves the examination of tissue removed during surgery. The tissue is processed and slides are prepared for detailed study under a microscope. The findings are then compiled into a report to help guide your treatment plan.

This service was performed 100 times for 98 patients

Surgical pathology consultation and report on referred slides prepared elsewhere

A surgical pathology consultation involves reviewing slides prepared at a different lab to confirm or clarify a diagnosis. It's a second opinion to ensure accuracy. A report with findings and interpretations is then provided for your doctor's reference.

This service was performed 1,035 times for 961 patients

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
52D0661946
Facility Type
Independent
Certificate Effective Date
February 13, 2025
Certificate Expiration Date
February 12, 2027
Laboratory Director
DR. SCOTT W. KELLEY
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Dermpath Diagnostics Of Wi on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha 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 1164494142, 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 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
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
4
Doubled → 8
Pos 8
1
Unchanged
Pos 9
4
Doubled → 8
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 4 → 8 4 → 8 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 1 + 1 + 2 + 4 + 8 + 9 + 8 + 1 + 8 + 24 = 68

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

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1164494142.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Clinical Medical Laboratory
12805 W BURLEIGH RD, SUITE 200
BROOKFIELD, WI 53005
Pathology (Dermatopathology)
12805 W BURLEIGH RD, SUITE 200
BROOKFIELD, WI 53005
Pathology (Dermatopathology)
12805 W BURLEIGH RD, SUITE 200
BROOKFIELD, WI 53005

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164494142, enumerated as an "organization" on February 03, 2006.

The provider is located at 12805 W BURLEIGH RD SUITE 200 BROOKFIELD, WI 53005 and the phone number is (262) 797-6434.

Clinical Medical Laboratory with taxonomy code 291U00000X.

The provider might be accepting Accepts: CareSource (Common Ground Healthcare), Medica,. Please consult your insurance carrier or call the provider to verify.