Individual provider Active NPI

Thomas Walter Guziejewski, M.D.

  • General Practice Physician
  • Anchorage, AK
National Provider Identifier
1356630867
Registry record updated Jul 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
3595 Issued in AK
Practice address
2110 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4154
Phone
(907) 336-2273
Fax
(907) 336-2276
NPI assigned
Apr 5, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 3595 AK Primary
General Practice Physician 208D00000X 0036955 WA

Addresses

Primary practice location

2110 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4154

Mailing address

2110 E Northern Lights Blvd Ste 101
Anchorage, AK 99508-4154
Phone (907) 336-2273

Other identifiers 1

IdentifierTypeStateIssuer
MD9719MedicaidAK

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

LicenseStateTypeSpecialty
3595AKMDGeneral Practice Physician
0036955WAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311811200000",
    "number": "1356630867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E NORTHERN LIGHTS BLVD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084154",
            "telephone_number": "907-336-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E NORTHERN LIGHTS BLVD STE 101",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084154",
            "telephone_number": "907-336-2273",
            "fax_number": "907-336-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUZIEJEWSKI",
        "first_name": "THOMAS",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AK",
            "license": "3595",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "0036955",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9719",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2011; 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.