Individual provider Active NPI

Brian Stanley Bogdanowicz, PHARMD, BCACP

  • Pharmacist
  • Scottsdale, AZ
National Provider Identifier
1063961225
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S022199 Issued in AZ
Practice address
15990 N Greenway Hayden Loop Ste D100
Scottsdale, AZ 85260-2269
Phone
(877) 662-6633
Fax
(877) 662-6355
NPI assigned
Sep 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S022199 AZ Primary

Addresses

Primary practice location

15990 N Greenway Hayden Loop Ste D100
Scottsdale, AZ 85260-2269

Mailing address

4046 W Abraham LN
Glendale, AZ 85308-4772
Phone (815) 412-4795

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
S022199AZMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sina Drug LLC CurrentSince Feb 12, 2023 Accepting new patients

Locations

15990 N Greenway Hayden Loop
Ste D100
Scottsdale, AZ 85260

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1063961225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4046 W ABRAHAM LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084772",
            "telephone_number": "815-412-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15990 N GREENWAY HAYDEN LOOP STE D100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602269",
            "telephone_number": "877-662-6633",
            "fax_number": "877-662-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGDANOWICZ",
        "first_name": "BRIAN",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S022199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.