Individual provider Active NPI

Andrew David Bowman, MD

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1306409586
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A180444 Issued in CA
Practice address
3234 Marysville Blvd
Sacramento, CA 95815-1411
Phone
(916) 454-2345
NPI assigned
Apr 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A180444 CA Primary

Addresses

Primary practice location

3234 Marysville Blvd
Sacramento, CA 95815-1411

Mailing address

1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220824002697 CA Practitioner - Pediatric Medicine 0446633432 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A180444CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elica Health Centers CurrentSince Aug 11, 2022 Accepting new patients
Elica Health Centers Current Accepting new patients
Elica Health Centers CurrentSince Aug 11, 2022 Accepting new patients

Locations

1750 Wright St
Ste 1
Sacramento, CA 95825

1860 Howe Ave
Ste 440
Sacramento, CA 95825

3234 Marysville Blvd
Sacramento, CA 95815
Phone (916) 646-1200

1276 Halyard Dr
West Sacramento, CA 95691

155 15th St
Ste A
West Sacramento, CA 95691
Phone (916) 375-8981

Organizations & group practices 3

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": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1306409586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3234 MARYSVILLE BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958151411",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWMAN",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-07-15",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A180444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.