Individual provider Active NPI

William F Bzdawka, PHARMD, MD

  • Pulmonary Disease Physician
  • Saint Louis, MO
National Provider Identifier
1831452671
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
20109033505 Issued in MO
Practice address
12700 Southfork Rd Ste 280
Saint Louis, MO 63128
Phone
(314) 892-6565
NPI assigned
Jun 18, 2012
Last updated
Aug 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2010037345 MO
Pharmacist 183500000X 15693040 WI
Internal Medicine Physician 207R00000X 64188-20 WI
Pulmonary Disease Physician 207RP1001X 20109033505 MO Primary

Addresses

Primary practice location

12700 Southfork Rd Ste 280
Saint Louis, MO 63128

Mailing address

12700 Southfork Rd Ste 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

Other practice location 1

600 Highland Ave
H4/831
Madison, WI 53792-0001
Phone (414) 861-2811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190906002626 MO Practitioner - Pulmonary Disease 1153544721 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Saint Louis University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Pulmonology - St. Louis, LLCGroup PAC ID 2365599925, 23 clinicians

Practice addresses (Care Compare)

12700 Southfork Rd
Suite 280
Saint Louis, MO 63128-3287
Phone (314) 892-6565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
2010037345MOMDPharmacist
15693040WIMDPharmacist
64188-20WIMDInternal Medicine Physician
20109033505MOMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Pulmonology - St. Louis, LLC Pulmonary Disease CurrentSince Jan 1, 2020 Accepting new patients

Locations

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

12700 Southfork Rd
Ste 280
Saint Louis, MO 63128
Phone (314) 525-4990

621 S New Ballas Rd
Ste 228A
Saint Louis, MO 63141
Phone (314) 251-4966

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1831452671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283287",
            "telephone_number": "314-892-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD STE 280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-892-6565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Highland Ave",
            "address_2": "H4/831",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537920001",
            "country_code": "US",
            "telephone_number": "414-861-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BZDAWKA",
        "first_name": "WILLIAM",
        "middle_name": "F",
        "credential": "PHARMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MO",
            "license": "2010037345",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "15693040",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "64188-20",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "20109033505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.