NPIMap

Individual provider Active NPI

Andrew Pitzak, DO

  • Internal Medicine Physician
  • Grants Pass, OR
National Provider Identifier
1679534002
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO23532 Issued in OR
Practice address
495 Ramsey Ave
Grants Pass, OR 97527-5681
Phone
(541) 476-6644
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO23532 OR Primary

Addresses

Primary practice location

495 Ramsey Ave
Grants Pass, OR 97527-5681

Mailing address

495 Ramsey Ave
Grants Pass, OR 97527-5681
Phone (541) 476-6644

Other identifiers 1

IdentifierTypeStateIssuer
287023MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512000027 OR Practitioner - Internal Medicine 2264421452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grants Pass Clinic LLPGroup PAC ID 9234123977, 16 clinicians

Practice addresses (Care Compare)

495 SW Ramsey Ave
Grants Pass, OR 97527-5681
Phone (541) 476-6644

Hospital & facility affiliations

  • Riverside Home Health Care Home health agency, Grants Pass, OR, CCN 387143
  • Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
  • Accentcare Home Health of Rogue Valley, LLC Home health agency, Medford, OR, CCN 387098
  • Riverside Hospice Hospice, Grants Pass, OR, CCN 381582
  • Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy88
Upper gastrointestinal (GI) endoscopy for acid reflux19
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO23532ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asante Three Rivers Medical Center, LLC CurrentSince Mar 1, 2011 Accepting new patients
Grants Pass Clinic LLP Internal Medicine CurrentSince May 31, 2006 Accepting new patients

Locations

495 SW Ramsey Ave
Grants Pass, OR 97527
Phone (541) 476-6644

Interoperability endpoints

  • Direct secure messaging: andrewpitzak@grantspass.allscriptsdirect.net
  • Direct secure messaging: andrewpitzak@gpc.allscriptsdirect.net

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1679534002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275681",
            "telephone_number": "541-476-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275681",
            "telephone_number": "541-476-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITZAK",
        "first_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "DO23532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287023",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

Verify at the official NPI Registry.