{
  "npi": "1205242641",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "YILAN",
    "authorized_official_last_name": "CHANG",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_telephone_number": "4408260384",
    "authorized_official_title_or_position": "President",
    "enumeration_date": "2014-07-07",
    "last_updated": "2019-01-13",
    "organization_name": "BAYLESS PATHMARK INC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1400 W MAIN ST",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BELLEVUE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "419-484-5415",
      "postal_code": "448119088",
      "state": "OH",
      "telephone_number": "419-483-4040"
    },
    {
      "address_1": "19250 BAGLEY RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "MIDDLEBURG HEIGHTS",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "440-826-4018",
      "postal_code": "441303347",
      "state": "OH",
      "telephone_number": "440-826-0384"
    }
  ],
  "taxonomies": [
    {
      "code": "207ZP0102X",
      "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
      "license": null,
      "primary": true,
      "state": "OH",
      "taxonomy_group": "193400000X - Single Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Allopathic & Osteopathic Physicians — Pathology, Anatomic Pathology & Clinical Pathology",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "22",
        "medicare_type": "Physician/Pathology"
      }
    ]
  }
}