Individual provider Active NPI

Andre Ali Hejazi, PHARMD

  • Pharmacist
  • Salt Lake City, UT
National Provider Identifier
1457217077
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10911747-1701 Issued in UT
Practice address
3044 E Pineview Dr
Salt Lake City, UT 84121-3407
Phone
(801) 652-3164
NPI assigned
Dec 29, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10911747-1701 UT Primary

Addresses

Primary practice location

3044 E Pineview Dr
Salt Lake City, UT 84121-3407

Mailing address

3044 E Pineview Dr
Salt Lake City, UT 84121-3407

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
10911747-1701UTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1457217077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 E PINEVIEW DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841213407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 E PINEVIEW DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841213407",
            "telephone_number": "801-652-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEJAZI",
        "first_name": "ANDRE",
        "middle_name": "ALI",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "10911747-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.