Active NPI
Krystyna Antonina Pekalska, M.D.
- Internal Medicine Physician
- Salem, OR
National Provider Identifier
1033220264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- OR MD20789
- Practice address
- 2400 Lancaster Dr NE
Salem, OR 97305-1221 - Phone
- (503) 361-5400
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OR MD20789 | OR | Primary |
Addresses
Primary practice location
2400 Lancaster Dr NE
Salem, OR 97305-1221
Mailing address
741 Hazeltine Ave SE
Salem, OR 97306-9352
Phone (503) 365-7869
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1017441 | Medicaid | OR |
Other names 1
- Dr. Krystyna Wagrowska
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OR MD20789 | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033220264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "741 HAZELTINE AVE SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973069352",
"telephone_number": "503-365-7869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 LANCASTER DR NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973051221",
"telephone_number": "503-361-5400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEKALSKA",
"first_name": "KRYSTYNA",
"middle_name": "ANTONINA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "OR MD20789",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017441",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRYSTYNA",
"last_name": "WAGROWSKA",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.