Individual provider Active NPI

Michael Yang

  • Pharmacist
  • Oakdale, MN
National Provider Identifier
1003577669
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
125468 Issued in MN
Practice address
985 Geneva Ave N
Oakdale, MN 55128-7409
Phone
(651) 731-8480
NPI assigned
Jan 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 125468 MN Primary

Addresses

Primary practice location

985 Geneva Ave N
Oakdale, MN 55128-7409

Mailing address

858 Clarence St
Saint Paul, MN 55106-5346
Phone (651) 373-7760

Other identifiers 1

IdentifierTypeStateIssuer
4073269OtherMNWALGREENS

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

State licenses

LicenseStateTypeSpecialty
125468MNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jan 17, 2022 Accepting new patients
Walgreen Co PastSince Jan 17, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1003577669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "858 CLARENCE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551065346",
            "telephone_number": "651-373-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 GENEVA AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551287409",
            "telephone_number": "651-731-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WALGREENS",
            "identifier": "4073269",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.