Individual provider Active NPI

Jonathan L Szkotak, PHARM.D.

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1255601522
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
66330 Issued in CA
Practice address
801 University Blvd SE, Suite 208
Msc12 7120, 1 Unm
Albuquerque, NM 87106
Phone
(505) 925-2432
NPI assigned
Jan 4, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 66330 CA Primary

Addresses

Primary practice location

801 University Blvd SE, Suite 208
Msc12 7120, 1 Unm
Albuquerque, NM 87106

Mailing address

801 University Blvd SE, Suite 208
Msc12 7120, 1 Unm
Albuquerque, NM 87106

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
66330CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1255601522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 UNIVERSITY BLVD SE, SUITE 208",
            "address_2": "MSC12 7120, 1 UNM",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 UNIVERSITY BLVD SE, SUITE 208",
            "address_2": "MSC12 7120, 1 UNM",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87106",
            "telephone_number": "505-925-2432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZKOTAK",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "66330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.