Individual provider Active NPI

Ghaleb Ismail

  • Pharmacist
  • Pittsburgh, PA
National Provider Identifier
1407434590
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302413057 Issued in MI
Practice address
3600 Forbes Ave Ste 140
Pittsburgh, PA 15213-3410
Phone
(412) 647-5815
NPI assigned
Mar 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302413057 MI Primary

Addresses

Primary practice location

3600 Forbes Ave Ste 140
Pittsburgh, PA 15213-3410

Mailing address

500 Kingsbury Ave
Dearborn, MI 48128-1521
Phone (313) 213-0405

Other practice location 1

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 324-3772

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
5302413057MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodward Detroit CVS, L.L.C. PastSince Apr 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1407434590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KINGSBURY AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281521",
            "telephone_number": "313-213-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE STE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410",
            "telephone_number": "412-647-5815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "734-324-3772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "GHALEB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.