Active NPI
Andrew J Poplawski, PA-C
- Medical Physician Assistant
- Puyallup, WA
National Provider Identifier
1487717716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA15223
- Practice address
- 3908 10TH St SE
Puyallup, WA 98374-2188 - Phone
- (253) 848-5951
- Fax
- (253) 845-7073
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA15223 | TX | Primary |
Addresses
Primary practice location
3908 10TH St SE
Puyallup, WA 98374-2188
Mailing address
1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 358-0285
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3908PO | Other | WA | REGENCE RIDER |
| 0198405 | Other | WA | LABOR & INDUSTRIES |
| 8371650 | Medicaid | WA | |
| 8906243 | Other | WA | L&I CVC |
| P00243340 | Other | WA | MEDICARE RAILROAD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bsa Physicians Group Inc | Current | Accepting new patients |
Locations
1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000
1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129
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.
-
- Internal Medicine Physician
- Amarillo, TX
- NPI 1457696916
-
- Family Medicine Physician
- Amarillo, TX
- NPI 1144668765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656460800000",
"number": "1487717716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 WALLACE BLVD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791061799",
"telephone_number": "806-358-0285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3908 10TH ST SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742188",
"telephone_number": "253-848-5951",
"fax_number": "253-845-7073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POPLAWSKI",
"first_name": "ANDREW",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2022-06-29",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA15223",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE RIDER",
"identifier": "3908PO",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "0198405",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8371650",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "L&I CVC",
"identifier": "8906243",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00243340",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.