Mastan Ramprasad Gangisetti, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60097582 Issued in WA

Practice address

1600 E Chestnut Ave
Yakima, WA 98901-2174

Phone

(509) 248-3855

Fax

(509) 452-5203

NPI assigned

Nov 13, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1104222488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E CHESTNUT AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012174",
            "telephone_number": "509-248-3855",
            "fax_number": "509-452-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E CHESTNUT AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989012174",
            "telephone_number": "509-248-3855",
            "fax_number": "509-452-5203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGISETTI",
        "first_name": "MASTAN RAMPRASAD",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60097582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PH60097582",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Yakima, WA
• Providers in Yakima, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.