THREE RIVERS PATHOLOGY PA (NPI# 1003878661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003878661 |
| Entity Type | Organization |
| Organization Name | THREE RIVERS PATHOLOGY PA |
| Practice Address |
2664 Patton Road Roseville MN 55113 |
| Mailing Address |
Po Box 1450 N W 5737 Minneapolis MN 55485-5737 |
| Practice Telephone | 6516359700 |
| Practice Fax Number | 6516359026 |
| Mailing Telephone | 6516359700 |
| Mailing Fax Number | 6516359026 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LARS T CONWAY (PRESIDENT) |
| Authorized Official Telephone | 6516359700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| X | 207ZC0500X |
Pathology Specialization: Cytopathology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | RR MEDICARE | C03199 | 01 |
| MN | BCBS | 13984TH | 01 |
| Street Address |
2664 PATTON ROAD |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184776999 | Wilson Eng Jung Soohoo | Pathology | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2007-01-18 |
| 1093887804 | Beverly J. Myers | Pathology | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2006-11-15 |
| 1083792741 | Richard N. Astorino | Pathology | 1600 Eureka Rd, Roseville, CA 95661-3027 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255697470 | Xiangrong He | Pathology | Mayo Clinic 200 1st Street Sw, Rochester, MN 55905-0341 | 2012-04-02 |
| 1588989289 | Barbara A Burke | Pathology | 7009 Cheyenne Trail, Chanhassen, MN 55317-7513 | 2010-04-06 |
| 1144457466 | Leah Ann Dvorak | Pathology | 301 Becker Avenue Sw, Willmar, MN 56201-3302 | 2009-06-12 |
| 1437190659 | Glenn Carter Faith | Pathology | 1004 1st St Nw, Rochester, MN 55901-6229 | 2006-06-09 |
| 1154305324 | Mark Luquette | Pathology | 500 Harvard St Se Ste 609, Minneapolis, MN 55455-0363 | 2005-12-01 |
| 1922650563 | Matthew Cecchini | Pathology | Mayo Clinic 200 First St Sw, Rochester, MN 55905-0001 | 2019-07-14 |
| 1134681182 | Maria Adelita Vizcaino Villalobos | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2019-04-01 |
| 1376008755 | Oyedele Adeyi | Pathology | 2450 Riverside Ave, Minneapolis, MN 55454-1450 | 2019-02-09 |
| 1689141335 | Reade Alan Quinton | Pathology | 200 1st St Sw, Rochester, MN 55905-0001 | 2018-10-31 |
| 1801381207 | Krasimira A Rozenova | Pathology | 200 1st St Sw, Rochester, MN 55905 | 2018-06-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.