Individual provider Active NPI

Beimnet Asmerom Abraha, PHARMD

  • Pharmacist
  • Wauwatosa, WI
National Provider Identifier
1003420720
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20401-40 Issued in WI
Practice address
2275 N Mayfair Rd
Wauwatosa, WI 53226-2207
Phone
(414) 774-4821
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20401-40 WI Primary

Addresses

Primary practice location

2275 N Mayfair Rd
Wauwatosa, WI 53226-2207

Mailing address

1405 Rockridge Rd Apt 260
Waukesha, WI 53188-2893
Phone (408) 807-9157

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
20401-40WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1003420720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 ROCKRIDGE RD APT 260",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882893",
            "telephone_number": "408-807-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262207",
            "telephone_number": "414-774-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHA",
        "first_name": "BEIMNET",
        "middle_name": "ASMEROM",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "20401-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.