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THE PATHOLOGY GROUP, INC.
NPI 1316196892
Pathology - Anatomic Pathology & Clinical Pathology in Fullerton, CA

Active since September 09, 2008
101 E VALENCIA MESA DR, FULLERTON, CA 92835(714) 446-7505(714) 992-3055 Get Directions Write a Review

NPPES record last updated: August 5, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 5, 2025, Feb 24, 2025 (2 updates tracked since 2025).

About The Pathology Group, Inc. NPPES

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

THE PATHOLOGY GROUP, INC. (NPI 1316196892), doing business as St Jude Pathology Medical Group, is a healthcare organization registered as an anatomic pathology & clinical pathology in Fullerton, California and active in the NPI registry since September 2008. The organization lists Mark Boonyasampant, President, as its authorized official.

NPPES Registry Identity

NPI1316196892
Entity TypeOrganization
Primary Taxonomy207ZP0102X
Legal Business NameTHE PATHOLOGY GROUP, INC.
Location Address101 E VALENCIA MESA DRFullerton, CA 92835-3809
Mailing AddressFile 749241Los Angeles, CA 90074-0001 · (714) 446-7505 · Fax (714) 992-3055
Phone(714) 446-7505
Fax(714) 992-3055
Organization SubpartNo
Authorized OfficialMark BoonyasampantPresident · (714) 446-7505
Enumeration DateSeptember 9, 2008
Last NPPES UpdateAugust 5, 20252 updates tracked since enumeration
NPPES CertifiedAugust 5, 2025
✔ NPI 1316196892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
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.
101 E VALENCIA MESA DR, Fullerton, CA 92835
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Other Names 1

Doing Business AsSt Jude Pathology Medical Group

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Pathology Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to The Pathology Group, Inc., which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Mark Boonyasampant, M.D.
Pathology
NPI 1396037537
101 E VALENCIA MESA DR
Fullerton, CA 92835
(510) 388-7271
✔ PECOS✔ Accepts MedicareSame address
Sandhya John, M.D.
Pathology
NPI 1528402427
101 E VALENCIA MESA DR
Fullerton, CA 92835
(714) 446-7505
✔ PECOS✔ Accepts MedicareSame address
Aditya Kuwadekar, M.D.
Pathology
NPI 1790139285
101 E VALENCIA MESA DR
Fullerton, CA 92835
(714) 446-7505
✔ PECOS✔ Accepts MedicareSame address
Yi Zhuang, M.D.
Pathology
NPI 1679830608
4301 NORTHSTAR WAY
Modesto, CA 95356
(209) 577-1200
✔ PECOS✔ Accepts Medicare316 mi
Junming Fang, MD
Pathology
NPI 1902984552
2200 OFARRELL ST
San Francisco, CA 94115
(415) 833-2000
✔ PECOS✔ Accepts Medicare369 mi
John Broussard, MD
Pathology
NPI 1326509977
901 HARBORSIDE DR
Galveston, TX 77550
(786) 843-7869
✔ PECOS✔ Accepts Medicare1,394 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 The Pathology Group, Inc.'s NPI number?

The NPI number for The Pathology Group, Inc. is 1316196892. It was assigned to this organization in the NPPES registry on September 9, 2008. The provider is doing business as St Jude Pathology Medical Group.

Where is The Pathology Group, Inc. located?

The Pathology Group, Inc. is located at 101 E Valencia Mesa Dr, Fullerton, CA 92835. The listed phone number is (714) 446-7505.

What is The Pathology Group, Inc.'s specialty?

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

Is The Pathology Group, Inc. enrolled in Medicare?

Yes. The Pathology Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through The Pathology Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Pathology, reassign their Medicare billing to The Pathology Group, Inc.. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for The Pathology Group, Inc. was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.