{"npi":"1104851625","type":"NPI-2","status":"active","name":{"display":"Tamarac Medical INC","other":[],"organization_name":"TAMARAC MEDICAL INC","authorised_official":"Richard Rosenbaum"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":"CO","license":"06D0899927"}]},"addresses":[{"purpose":"LOCATION","street_1":"3959 E ARAPAHOE RD","city":"CENTENNIAL","state":"CO","postal_code":"801222070","country_code":"US","street_2":"STE 100","phone":"3037941083","fax":"3037941093"},{"purpose":"MAILING","street_1":"3959 E ARAPAHOE RD","city":"CENTENNIAL","state":"CO","postal_code":"801222070","country_code":"US","street_2":"STE 100","phone":"3037941083","fax":"3037941093"}],"license":{"state":"CO","number":"06D0899927"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"00666014A","state":"GA","issuer":null},{"type_code":"05","label":"Medicaid","value":"100759250A","state":"OK","issuer":null},{"type_code":"05","label":"Medicaid","value":"343719100","state":"MN","issuer":null},{"type_code":"05","label":"Medicaid","value":"100245360A","state":"KS","issuer":null},{"type_code":"05","label":"Medicaid","value":"146949709","state":"AR","issuer":null},{"type_code":"05","label":"Medicaid","value":"1662275","state":"LA","issuer":null},{"type_code":"05","label":"Medicaid","value":"705766301","state":"MO","issuer":null},{"type_code":"05","label":"Medicaid","value":"08002669","state":"CO","issuer":null},{"type_code":"05","label":"Medicaid","value":"200061470","state":"IN","issuer":null},{"type_code":"05","label":"Medicaid","value":"000100188","state":"VA","issuer":null},{"type_code":"05","label":"Medicaid","value":"0123731","state":"MS","issuer":null},{"type_code":"05","label":"Medicaid","value":"J4463","state":"NM","issuer":null},{"type_code":"05","label":"Medicaid","value":"0153711","state":"OH","issuer":null},{"type_code":"01","label":"Other","value":"06D0899927","state":null,"issuer":"CLIA NUMBER"},{"type_code":"05","label":"Medicaid","value":"6705072000","state":"WV","issuer":null},{"type_code":"05","label":"Medicaid","value":"C05800044","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20040322000430","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"CO","pac_id":"8628969680"}]},"enumeration_date":"2006-07-12","last_updated":"2016-03-21","_meta":{"source":"NPPES","snapshot_date":"2016-03-21","doc_url":"https://findmynpi.com/api"}}