NPIMap

Individual provider Active NPI

Kimberly Ann Depczynski, PHARMD

  • Pharmacist
  • North Tonawanda, NY
National Provider Identifier
1649797879
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
063302 Issued in NY
Practice address
343 Meadow Dr
North Tonawanda, NY 14120-2815
Phone
(716) 694-2001
Fax
(716) 694-6771
NPI assigned
Aug 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 063302 NY Primary

Addresses

Primary practice location

343 Meadow Dr
North Tonawanda, NY 14120-2815

Mailing address

343 Meadow Dr
North Tonawanda, NY 14120-2815
Phone (716) 694-2001

Other practice location 1

2330 Niagara Falls Blvd
Tonawanda, NY 14150-4759
Phone (716) 693-9666 ext. 3

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
063302NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation PastSince Dec 15, 2019 Accepting new patients
Eckerd Corporation PastSince Dec 15, 2019 Accepting new patients

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": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1649797879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 MEADOW DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202815",
            "telephone_number": "716-694-2001",
            "fax_number": "716-694-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 MEADOW DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202815",
            "telephone_number": "716-694-2001",
            "fax_number": "716-694-6771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 Niagara Falls Blvd",
            "address_purpose": "LOCATION",
            "city": "Tonawanda",
            "state": "NY",
            "postal_code": "141504759",
            "country_code": "US",
            "telephone_number": "716-693-9666 x3",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPCZYNSKI",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "063302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.