Active NPI
Melissa Priyanthie Munagamagedon
- Pharmacist
- Goodyear, AZ
National Provider Identifier
1093415754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S026354
- Practice address
- 9800 S Estrella Pkwy
Goodyear, AZ 85338-7141 - Phone
- (623) 255-3649
- NPI assigned
- Mar 9, 2023
- Last updated
- Mar 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S026354 | AZ | Primary |
Addresses
Primary practice location
9800 S Estrella Pkwy
Goodyear, AZ 85338-7141
Mailing address
23326 W Pima St
Buckeye, AZ 85326-4042
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
| License | State | Type | Specialty |
|---|---|---|---|
| S026354 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
9800 S Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 255-3439
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1093415754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23326 W PIMA ST",
"city": "BUCKEYE",
"state": "AZ",
"postal_code": "853264042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9800 S ESTRELLA PKWY",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853387141",
"telephone_number": "623-255-3649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNAGAMAGEDON",
"first_name": "MELISSA",
"middle_name": "PRIYANTHIE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-09",
"last_updated": "2023-03-09",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S026354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.