Individual provider Active NPI

Alexander Bulochnik Shteynberg, PHARM.D., MBA

  • Ambulatory Care Pharmacist
  • Portland, OR
National Provider Identifier
1265936058
Registry record updated Mar 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
0012559 Issued in OR
Practice address
800 SW 13TH Ave
Portland, OR 97205-1999
Phone
(503) 221-0161
NPI assigned
Mar 19, 2018
Last updated
Mar 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X 0012559 OR Primary

Addresses

Primary practice location

800 SW 13TH Ave
Portland, OR 97205-1999

Mailing address

2815 NW Cornell Rd
Portland, OR 97210-2590
Phone (515) 779-4088

Other names 1

  • Alexander Bulochnik Other name

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
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0012559ORMDAmbulatory Care Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521417600000",
    "number": "1265936058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102590",
            "telephone_number": "515-779-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051999",
            "telephone_number": "503-221-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULOCHNIK SHTEYNBERG",
        "first_name": "ALEXANDER",
        "credential": "PHARM.D., MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OR",
            "license": "0012559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDER",
            "last_name": "BULOCHNIK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.