Active NPI
Andrew S Bzowyckyj, PHARMD
- Pharmacist
- Beaverton, OR
National Provider Identifier
1740410620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH-0017037
- Practice address
- 1960 NW 167TH PL Ste 100
Beaverton, OR 97006-4805 - Phone
- (503) 672-6000
- Fax
- (503) 672-6001
- NPI assigned
- Jul 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 119735 | MN | |
| Pharmacotherapy Pharmacist | 1835P1200X | 2011024490 | MO | |
| Pharmacotherapy Pharmacist | 1835P1200X | 11371 | CT | |
| Pharmacist | 183500000X | RPH-0017037 | OR | Primary |
Addresses
Primary practice location
1960 NW 167TH PL Ste 100
Beaverton, OR 97006-4805
Mailing address
PO Box 3808
Portland, OR 97208-3808
Phone (503) 413-3900
Other practice location 1
2310 Holmes St
The Diabetes Center
Kansas City, MO 64108-2602
Phone (816) 404-4070
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
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0017037 | OR | MD | Pharmacist |
| 11371 | CT | MD | Pharmacotherapy Pharmacist |
| 119735 | MN | MD | Pharmacotherapy Pharmacist |
| 2011024490 | MO | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583971200000",
"number": "1740410620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3808",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083808",
"telephone_number": "503-413-3900",
"fax_number": "503-413-3710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1960 NW 167TH PL STE 100",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970064805",
"telephone_number": "503-672-6000",
"fax_number": "503-672-6001"
}
],
"practiceLocations": [
{
"address_1": "2310 Holmes St",
"address_2": "The Diabetes Center",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082602",
"country_code": "US",
"telephone_number": "816-404-4070",
"fax_number": "816-404-4075",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BZOWYCKYJ",
"first_name": "ANDREW",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-25",
"last_updated": "2020-03-12",
"certification_date": "2020-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MN",
"license": "119735",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MO",
"license": "2011024490",
"primary": false
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CT",
"license": "11371",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0017037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.