Individual provider Active NPI

Katarzyna Modrzejewska, PHARMD.

  • Pharmacist
  • Laguna Woods, CA
National Provider Identifier
1487473989
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
89872 Issued in CA
Practice address
24167 Paseo de Valencia
Laguna Woods, CA 92637-3110
Phone
(949) 586-3503
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0024686 CO
Pharmacist 183500000X 89872 CA Primary

Addresses

Primary practice location

24167 Paseo de Valencia
Laguna Woods, CA 92637-3110

Mailing address

26891 Aliso Creek Rd
Aliso Viejo, CA 92656-3392

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
0024686COMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Longs Drug Store California LLC PastSince Oct 13, 2024 Accepting new patients
Longs Drug Stores California LLC PastSince Oct 13, 2024 Accepting new patients

Organizations & group practices 2

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": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1487473989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26891 ALISO CREEK RD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926563392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24167 PASEO DE VALENCIA",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373110",
            "telephone_number": "949-586-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRZEJEWSKA",
        "first_name": "KATARZYNA",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CO",
            "license": "0024686",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "89872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Woods, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.