LABORATORY MEDICINE CONSULTANTS LTD
NPI 1962463786
Clinical Medical Laboratory in Las Vegas, NV

Q: What is Laboratory Medicine Consultants Ltd's NPI number?

The NPI number for Laboratory Medicine Consultants Ltd is 1962463786. It was assigned to this organization in the NPPES registry on March 31, 2006.

Q: What is Laboratory Medicine Consultants Ltd's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Active since March 31, 2006

7455 W WASHINGTON AVE, SUITE 301, LAS VEGAS, NV 89128(702) 732-2310(702) 732-2310 Get Directions Write a Review

NPPES record last updated: March 23, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 23, 2016, Mar 16, 2016 (2 updates tracked since 2016).

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About Laboratory Medicine Consultants Ltd NPPES

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

LABORATORY MEDICINE CONSULTANTS LTD (NPI 1962463786) is a healthcare organization registered as a clinical medical laboratory in Las Vegas, Nevada and active in the NPI registry since March 2006. The organization lists Michael C. Grattendick, Vice President, as its authorized official.

NPPES Registry Identity

NPI1962463786

Entity TypeOrganization

Primary Taxonomy291U00000X

Legal Business NameLABORATORY MEDICINE CONSULTANTS LTD

Location Address7455 W WASHINGTON AVE, SUITE 301Las Vegas, NV 89128-4337

Mailing Address11025 Rca Center Drive, Suite 300Palm Beach Gardens, FL 33410-4269 · (561) 626-5512 · Fax (561) 626-4530

Phone(702) 732-2310

Fax(702) 732-2310

Organization SubpartNo

Authorized OfficialMichael C. GrattendickVice President · (561) 626-5512

Enumeration DateMarch 31, 2006

Last NPPES UpdateMarch 23, 20162 updates tracked since enumeration

✔ NPI 1962463786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Medical LaboratoryLaboratories

Taxonomy Code291U00000X

Definition

(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.

7455 W WASHINGTON AVE, Las Vegas, NV 89128

Open in Google Maps ↗

Other Identifiers 2

Medicaid100513165NV

Medicare PINV35182NV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross Blue Shield of Arizona and more.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)

Laboratory Medicine Consultants Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 40 clinicians reassign Medicare billing to Laboratory Medicine Consultants Ltd, which bills Medicare for the services they deliver. Of these, 21 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Pathology38

Dermatology1

Dermatopathology1

Nearest to this location (20)

See all 40

Rong Fan, M.D.

Pathology

NPI 1669648408

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(702) 732-3441

✔ PECOS✔ Accepts Medicare0.2 mi

Susan Karki, M.D.

Pathology

NPI 1023672052

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(702) 732-3441

✔ PECOS✔ Accepts Medicare0.2 mi

Whitney Banks

Pathology

NPI 1821356650

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS0.2 mi

Joel Bentz, MD

Pathology

NPI 1588754113

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

David Coon, M.D., PH.D.

Pathology

NPI 1508979295

7455 W WASHINGTON AVE SUITE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Kevin Golden, M.D, PH.D.

Pathology

NPI 1982804340

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Abel Gonzalez Longoria, M.D.

Pathology

NPI 1548488505

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(706) 832-2372

✔ PECOS✔ Accepts Medicare0.2 mi

Omar Khan, M.D.

Pathology

NPI 1720378003

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Ronald Knoblock, MD

Pathology

NPI 1669413084

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Michelle Mcnamara, MD

Pathology

NPI 1063437408

7455 W WASHINGTON AVE STE 104
Las Vegas, NV 89128

(702) 732-3441

✔ PECOS✔ Accepts Medicare0.2 mi

Sierra Musick, M.D.

Pathology

NPI 1366899916

7455 W WASHINGTON AVE
Las Vegas, NV 89128

(805) 701-1094

✔ PECOS✔ Accepts Medicare0.2 mi

Alpa Shah, M.D.

Pathology

NPI 1457779985

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Jing Sun, DO

Pathology

NPI 1821658485

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(702) 732-3441

✔ PECOS✔ Accepts Medicare0.2 mi

Julieta Tablante-Blanco, MD

Pathology

NPI 1750377495

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(702) 732-3441

✔ PECOS✔ Accepts Medicare0.2 mi

Brody Winn, M.D.

Pathology

NPI 1467679399

7455 W WASHINGTON AVE STE 301
Las Vegas, NV 89128

(877) 562-5227

✔ PECOS✔ Accepts Medicare0.2 mi

Damanzoopinder Samrao, M.D.

Pathology

NPI 1952545337

1707 W CHARLESTON BLVD STE 230
Las Vegas, NV 89102

(702) 671-2201

✔ PECOS✔ Accepts Medicare5.2 mi

Jonathan Hughes, MD PHD

Pathology

NPI 1073574935

3059 S MARYLAND PKWY STE 100
Las Vegas, NV 89109

(702) 732-3441

✔ PECOS✔ Accepts Medicare7.2 mi

David Marmaduke, MD

Pathology

NPI 1053372912

3059 S MARYLAND PKWY STE 100
Las Vegas, NV 89109

(702) 732-3441

✔ PECOS✔ Accepts Medicare7.2 mi

Brian Mcnally, MD

Pathology

NPI 1760459184

3059 S MARYLAND PKWY SUITE 100
Las Vegas, NV 89109

(702) 732-3441

✔ PECOS7.2 mi

Noel Yumiaco, MD

Pathology

NPI 1952362949

3059 S MARYLAND PARKWAY 100
Las Vegas, NV 89109

(702) 732-3441

✔ PECOS✔ Accepts Medicare7.2 mi

See all 40 clinicians

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

Areas of Expertise CMS Part B claims 47

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Pathology examination of tissue using a microscope, intermediate complexity 88305

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.

21,358 services10,127 patients

Special stained specimen slides to examine tissue, each additional procedure 88341

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.

1,092 services459 patients

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision G0145

This is a procedure to check for abnormal cells in the lower part of the womb or the birth canal. Cells are collected in a special fluid and prepared in a thin layer. They are then examined by an automated system and manually reviewed by a doctor for accuracy.

1,050 services1,050 patients

Cell examination of specimen, selective cellular enhancement technique 88112

Cell examination of a specimen using selective cellular enhancement technique is a lab process that improves the visibility of certain cells in a sample. It helps in identifying abnormalities or diseases. The process is non-invasive, safe, and aids in accurate diagnosis.

693 services600 patients

Special stained specimen slides to examine tissue, initial procedure 88342

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.

684 services607 patients

Pathology examination of tissue using a microscope, moderately low complexity 88304

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.

570 services500 patients

Evaluation of fine needle aspirate with interpretation and report 88173

This procedure involves using a thin needle to collect a small sample from an abnormal area or lump. The sample is then examined under a microscope to identify any potential issues. A report of the findings is provided for further analysis.

516 services400 patients

Microscopic genetic analysis of tumor, manual 88360

Microscopic genetic analysis of a tumor involves examining your tumor's genes under a microscope. This helps identify specific genetic changes in the tumor cells. This information can aid in diagnosing, predicting disease progression, and determining the most effective treatment options.

470 services202 patients

Detection test for candida species (yeast), amplified probe technique 87481

This test helps identify Candida, a type of fungus often present in the human body. An amplified probe technique is used, which enhances detection of the fungus in a sample. This method increases the accuracy of the test, helping to determine the best treatment.

469 services203 patients

Examination of archival tissue for genetic analysis 88363

Examination of archival tissue for genetic analysis involves studying previously collected tissue samples. This process helps detect any genetic alterations that may be linked to certain diseases. It's a crucial step in understanding your health and planning appropriate treatments.

424 services366 patients

Pap test, automated thin layer preparation; automated system and manual rescreening 88175

A Pap test is a screening tool that helps detect unusual cells. The automated thin layer preparation involves placing your cell sample in a thin layer on a slide. An automated system then scans the slide, and experts manually review any areas flagged by the system. This method enhances the accuracy of the results.

386 services341 patients

Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method G0416

This procedure involves taking a small tissue sample from your gland located beneath your bladder. The sample is then examined under a microscope by a pathologist to check for any abnormalities or diseases. This is a standard method to ensure your well-being.

372 services371 patients

Special stained specimen slides to examine tissue, each multiplex procedure 88344

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.

332 services135 patients

Special stained specimen slides to identify organisms including interpretation and report 88312

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.

308 services234 patients

Detection test by nucleic acid for human papillomavirus (hpv), high-risk types 87624

This test detects high-risk types of HPV, a common virus. It's done by analyzing a small sample of cells for the presence of HPV DNA. The aim is to identify any high-risk types early, as they may increase the risk of certain health issues.

261 services249 patients

Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test G0476

This service detects high-risk types of HPV, a common virus, by analyzing DNA or RNA. It's an essential part of cervical cancer screening, performed alongside the Pap test. This dual approach enhances accuracy, aiding early detection and treatment.

236 services236 patients

Special stained specimen slides to examine tissue including interpretation and report 88313

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.

220 services104 patients

Measurement of rna of bacteria in vaginal fluid specimen 81513

This is a lab test where a small sample of fluid is collected from the female body's lower region. The test measures the RNA (genetic material) of bacteria in the sample. This helps doctors understand the types and amounts of bacteria present, aiding in diagnosis and treatment.

181 services165 patients

Detection test by nucleic acid for organism, amplified probe technique 87798

A nucleic acid detection test is a procedure to identify specific organisms in your body. This test uses an amplified probe technique, which magnifies the genetic material of the organism, making it easier to detect. It's a precise way to diagnose infections.

164 services57 patients

Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique 87491

A detection test by nucleic acid for chlamydia trachomatis, amplified probe technique, is a test that identifies the presence of a specific bacteria in the body. This bacteria can cause various health issues. The technique amplifies the sample to improve accuracy.

128 services83 patients

Detection test by nucleic acid for trichomonas vaginalis (genital parasite), direct probe technique 87660

This test helps identify a common microscopic organism that can cause discomfort. It uses a direct probe technique, which involves analyzing a small sample from your body. The test detects the organism's unique genetic material (nucleic acid), confirming its presence.

126 services120 patients

Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique 87591

This is a lab test that checks for the presence of a specific bacteria called Neisseria gonorrhoeae in your body. It uses a technique called amplified probe, which makes many copies of the bacteria's genetic material (nucleic acid) to help detect it more easily.

121 services80 patients

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision G0123

This is a routine screening procedure where cells are collected from the lower female tract. The cells are placed in a special fluid, prepared in a thin layer for microscopic examination. This is done under the supervision of a medical professional to ensure accuracy.

121 services121 patients

Preparation of tissue for examination by removing any calcium present 88311

This procedure involves treating tissue samples to remove any calcium, which can interfere with the examination. The tissue is soaked in a special solution that safely dissolves the calcium, leaving the tissue intact for accurate analysis. This helps in making precise diagnoses.

106 services97 patients

Bone marrow, smear interpretation 85097

Bone marrow smear interpretation is a procedure where a small sample of your bone marrow is taken and examined under a microscope. This helps doctors identify any abnormal cells or signs of diseases such as anemia, leukemia, or infections. It's a crucial step in diagnosing various blood disorders.

95 services88 patients

Flow cytometry technique for dna or cell analysis, 16 or more markers 88189

Flow cytometry is a method used to measure and analyze cells. It uses a beam of light to detect up to 16 or more markers on cells, helping to identify their type, function, or abnormalities. This technique aids in diagnosing various health conditions.

95 services93 patients

Detection test by nucleic acid for herpes simplex virus, amplified probe technique 87529

This test uses an amplified probe technique to identify the presence of the herpes simplex virus in your body. It works by detecting the virus's genetic material, or nucleic acid. The test is accurate, reliable, and can help in early detection and treatment.

89 services43 patients

Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician G0124

This is a routine health check where a sample of cells is collected from the lower region of the female reproductive system. The sample is preserved and prepared using automated technology for detailed examination. A doctor interprets the results to check for any abnormalities.

83 services83 patients

Pap test 88141

A Pap test is a routine exam that checks for changes in cells that could signal a health concern. During this test, a small sample of cells is gently collected from the lower region of the body. The sample is then examined under a microscope to ensure everything looks normal.

75 services67 patients

Microscopic genetic analysis of tissue, computer-assisted technology, initial procedure, each multiplex procedure 88374

This procedure involves analyzing tissue at a genetic level using a microscope and advanced computer technology. The initial process involves the collection and preparation of tissue samples. Each multiplex procedure refers to the simultaneous testing of multiple genetic markers to identify abnormalities.

66 services15 patients

Detection of mycoplasma genitalium by dna or rna probe 87563

This procedure involves the use of special probes to identify the presence of a specific bacteria, Mycoplasma Genitalium, in your body. These probes detect the bacteria's unique DNA or RNA, helping to confirm if you have an infection.

59 services50 patients

Detection test by nucleic acid for strep (streptococcus, group b), amplified probe technique 87653

A detection test by nucleic acid for Group B Strep uses an amplified probe technique. This test identifies the presence of Group B Strep bacteria in the body. It involves collecting a sample, usually a swab, which is then examined in a lab for the bacteria's genetic material.

52 services46 patients

Pathology examination of tissue using a microscope, moderately high complexity 88307

A pathology examination of tissue with moderate complexity involves a detailed study of a small tissue sample from your body. Using a microscope, experts analyze the tissue's structure and cells to identify any abnormalities. This helps in diagnosing various health conditions accurately.

48 services37 patients

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique 87640

A detection test for Staphylococcus aureus uses a method called the amplified probe technique. This method identifies the bacteria's unique genetic material, or nucleic acid, helping to confirm its presence. It's a highly accurate way to detect this type of bacteria.

47 services41 patients

Cell examination of urine, manual 88120

A cell examination of urine, manually done, is a lab test where your urine is studied under a microscope. This helps identify any abnormal cells or substances in your urine, like bacteria or crystals, that could indicate health issues. It's a simple, non-invasive procedure.

39 services39 patients

Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 only 87625

This test identifies specific types of HPV, a common virus, by examining your body's cells for the virus's genetic material. It's specifically designed to detect types 16 and 18, which are often associated with certain health risks. The procedure is safe and simple.

32 services30 patients

Detection test for candida species (yeast), direct probe technique 87480

The detection test for Candida species uses a direct probe technique. This is a lab test where a sample is taken from your body, typically from the mouth or skin. The sample is then examined under a microscope to identify the presence of Candida, a type of yeast that can cause infection.

28 services27 patients

Detection test for gardnerella vaginalis (bacteria), direct probe technique 87510

This test helps find a certain type of bacteria called Gardnerella vaginalis. The direct probe technique uses a small sample from your body. This sample is then examined in a lab to see if this bacteria is present. This helps in identifying and treating any related health issues.

28 services27 patients

Pathology examination of specimen during surgery, first tissue block 88331

A pathology examination during surgery involves the immediate analysis of a removed tissue sample. This helps the surgeon make decisions during your operation. The "first tissue block" refers to the initial sample examined. It's a vital step to ensure your health.

28 services18 patients

Cell examination of urine, computer-assisted 88121

A cell examination of urine, computer-assisted, is a lab test where a computer helps analyze your urine sample. It aids in identifying any abnormal cells or substances that may indicate health issues. The process is painless and involves collecting a urine sample.

23 services23 patients

Cell examination of specimen, concentration technique 88108

Cell examination of a specimen using a concentration technique is a lab process that enhances the detection of cells in a sample. This method helps to focus on key areas of the sample, making it easier to spot abnormalities or changes. It's a crucial part of diagnosing and monitoring certain health conditions.

19 services18 patients

Microscopic genetic analysis of tissue, manual, initial procedure 88368

Microscopic genetic analysis of tissue is a test that examines your cells under a microscope. This helps to identify any genetic changes that could be causing health issues. It's the first step in a series of tests to pinpoint the root cause of your symptoms.

19 services17 patients

Microscopic genetic analysis of tissue, manual, each additional procedure 88369

Microscopic genetic analysis of tissue is a procedure where a small sample of your body tissue is examined under a microscope. This is done to study the genes in your cells. If more than one procedure is needed, each additional one involves repeating this process. It's a key part of diagnosing and managing many health conditions.

19 services17 patients

Pathology examination of tissue using a microscope, limited examination 88300

A pathology examination of tissue using a microscope is a procedure where a small sample of your tissue is observed under a microscope. This limited examination helps identify any abnormal cells or signs of disease, aiding in accurate diagnosis and treatment planning.

18 services13 patients

Surgical pathology consultation and report on referred slides prepared elsewhere 88321

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.

18 services18 patients

Pathology examination of tissue using a microscope 88302

A pathology examination of tissue involves studying a small sample of your body's cells under a microscope. This helps identify any abnormalities or diseases, such as cancer. The process is crucial for accurate diagnosis and treatment planning.

17 services15 patients

Pap test, manual screening 88142

A Pap test is a routine procedure that checks for unusual changes in cells. During the manual screening, a small sample of cells is gently collected from the lower region of the body. These cells are then examined under a microscope to ensure your health.

16 services16 patients

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 Laboratory Medicine Consultants Ltd's NPI number?

The NPI number for Laboratory Medicine Consultants Ltd is 1962463786. It was assigned to this organization in the NPPES registry on March 31, 2006.

Where is Laboratory Medicine Consultants Ltd located?

Laboratory Medicine Consultants Ltd is located at 7455 W Washington Ave Suite 301, Las Vegas, NV 89128. The listed phone number is (702) 732-2310.

What is Laboratory Medicine Consultants Ltd's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Is Laboratory Medicine Consultants Ltd enrolled in Medicare?

Yes. Laboratory Medicine Consultants Ltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Laboratory Medicine Consultants Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 40 clinicians in 3 Medicare specialties reassign their Medicare billing to Laboratory Medicine Consultants Ltd. 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. The largest specialties are Pathology (38), Dermatology (1) and Dermatopathology (1). Of these, 21 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Laboratory Medicine Consultants Ltd accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona and Molina Healthcare list Laboratory Medicine Consultants Ltd 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 Laboratory Medicine Consultants Ltd was last updated on March 23, 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.