Active NPI
Michael Anthony Haas
- Pharmacist
- Richfield, MN
National Provider Identifier
1629603097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 123963
- Practice address
- 6540 Penn Ave S
Richfield, MN 55423-1143 - Phone
- (612) 866-3040
- Fax
- (612) 866-3050
- NPI assigned
- Mar 6, 2020
- Last updated
- Mar 6, 2020
- 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 | 123963 | MN | Primary |
Addresses
Primary practice location
6540 Penn Ave S
Richfield, MN 55423-1143
Mailing address
6540 Penn Ave S
Richfield, MN 55423-1143
Phone (612) 866-3040
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 |
|---|---|---|---|
| 123963 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand St Paul CVS LLC | Past | Accepting new patients | |
| Grand St Paul CVS LLC | Past | 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, 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": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1629603097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6540 PENN AVE S",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554231143",
"telephone_number": "612-866-3040",
"fax_number": "612-866-3050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6540 PENN AVE S",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554231143",
"telephone_number": "612-866-3040",
"fax_number": "612-866-3050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-03-06",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "123963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.