Active NPI
Emmanuel Tesfaye, PHARM. D
- Pharmacist
- Lanham, MD
National Provider Identifier
1609178128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17450
- Practice address
- 4551 Forbes Blvd
Lanham, MD 20706-4325 - Phone
- (301) 918-6908
- NPI assigned
- Dec 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 17450 | MD | Primary |
Addresses
Primary practice location
4551 Forbes Blvd
Lanham, MD 20706-4325
Mailing address
5665 Thicket LN
Columbia, MD 21044-2557
Phone (410) 997-1726
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17450 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enchanted Medical LLC | Current | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291420800000",
"number": "1609178128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 THICKET LN",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210442557",
"telephone_number": "410-997-1726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4551 FORBES BLVD",
"city": "LANHAM",
"state": "MD",
"postal_code": "207064325",
"telephone_number": "301-918-6908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESFAYE",
"first_name": "EMMANUEL",
"name_prefix": "Dr.",
"credential": "PHARM. D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-12-04",
"last_updated": "2010-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.