Active NPI
Anh Ngo Soemadi, PHARMD
- Pharmacist
- Waukesha, WI
National Provider Identifier
1730868803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19548-40
- Practice address
- 725 American Ave
Waukesha, WI 53188-5031 - Phone
- (262) 928-2357
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23234 | IA | |
| Pharmacist | 183500000X | 19548-40 | WI | Primary |
Addresses
Primary practice location
725 American Ave
Waukesha, WI 53188-5031
Mailing address
W162N5517 Westwind Dr
Menomonee Falls, WI 53051-7828
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 |
|---|---|---|---|
| 19548-40 | WI | MD | Pharmacist |
| 23234 | IA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1730868803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W162N5517 WESTWIND DR",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530517828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 AMERICAN AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885031",
"telephone_number": "262-928-2357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOEMADI",
"first_name": "ANH",
"middle_name": "NGO",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "23234",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "19548-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.