GRANITE PEAKS PATHOLOGY
NPI 1205387008
Pathology - Anatomic Pathology & Clinical Pathology in Sandy, UT

Q: What is Granite Peaks Pathology II LLC.'s NPI number?

The NPI number for Granite Peaks Pathology II LLC. is 1205387008. It was assigned to this organization in the NPPES registry on October 18, 2016. The provider is doing business as Granite Peaks Pathology.

Q: What is Granite Peaks Pathology II LLC.'s specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Active since October 18, 2016

1393 E SEGO LILY DR, SANDY, UT 84092(801) 619-9000(801) 572-7616 Get Directions Write a Review

NPPES record last updated: October 18, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Granite Peaks Pathology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRANITE PEAKS PATHOLOGY (NPI 1205387008) is a healthcare organization registered as an anatomic pathology & clinical pathology in Sandy, Utah and active in the NPI registry since October 2016. The organization lists Robert Kyle Barnett, President, as its authorized official.

NPPES Registry Identity

NPI1205387008

Entity TypeOrganization

Primary Taxonomy207ZP0102X

Legal Business NameGRANITE PEAKS PATHOLOGY II LLC.

Location Address1393 E SEGO LILY DRSandy, UT 84092-4350

Mailing Address1393 E Sego Lily DrSandy, UT 84092-4350 · (801) 619-9000 · Fax (801) 572-7616

Phone(801) 619-9000

Fax(801) 572-7616

Organization SubpartNo

Authorized OfficialRobert Kyle BarnettPresident · (801) 619-9000

Enumeration DateOctober 18, 2016

✔ NPI 1205387008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

License✔ Licensed in UT · 2424607-1205

Definition

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.

1393 E SEGO LILY DR, Sandy, UT 84092

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Other Names 1

Doing Business AsGranite Peaks Pathology

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Granite Peaks Pathology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Granite Peaks Pathology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Todd Randolph, MD

Pathology

NPI 1740249192

5100 TALLEY RD STE 300
Little Rock, AR 72204

(501) 500-6640

✔ PECOS✔ Accepts Medicare1,138 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Granite Peaks Pathology II LLC.'s NPI number?

The NPI number for Granite Peaks Pathology II LLC. is 1205387008. It was assigned to this organization in the NPPES registry on October 18, 2016. The provider is doing business as Granite Peaks Pathology.

Where is Granite Peaks Pathology II LLC. located?

Granite Peaks Pathology II LLC. is located at 1393 E Sego Lily Dr, Sandy, UT 84092. The listed phone number is (801) 619-9000.

What is Granite Peaks Pathology II LLC.'s specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Granite Peaks Pathology II LLC. enrolled in Medicare?

Yes. Granite Peaks Pathology II LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Granite Peaks Pathology II LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pathology) reassigns their Medicare billing to Granite Peaks Pathology II LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Granite Peaks Pathology II LLC. accept?

Health plans from Molina Healthcare list Granite Peaks Pathology II LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Granite Peaks Pathology II LLC. was last updated on October 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.