NPIMap

Individual provider Active NPI

Yonas Asmamaw Mengistu, PHARMD

  • Pharmacist
  • Angleton, TX
National Provider Identifier
1679129514
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
50378 Issued in TX
Practice address
1801 N Velasco St
Angleton, TX 77515-3014
Phone
(979) 849-3028
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 50378 TX Primary

Addresses

Primary practice location

1801 N Velasco St
Angleton, TX 77515-3014

Mailing address

1801 N Velasco St
Angleton, TX 77515-3014

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wal-Mart Stores Texas, LLC PastSince Aug 18, 2019 Accepting new patients
Wal-Mart Stores Texas LLC PastSince Aug 18, 2019 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1679129514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N VELASCO ST",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775153014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N VELASCO ST",
            "city": "ANGLETON",
            "state": "TX",
            "postal_code": "775153014",
            "telephone_number": "979-849-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGISTU",
        "first_name": "YONAS",
        "middle_name": "ASMAMAW",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "50378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angleton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.