Individual provider Active NPI

Robenson Apibo-Tango, PHARM.D

  • Pharmacist
  • North Las Vegas, NV
National Provider Identifier
1962781633
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17611 Issued in NV
Practice address
4090 W Craig Rd Ste 101
North Las Vegas, NV 89032-2758
Phone
(702) 636-2054
Fax
(702) 636-2028
NPI assigned
Aug 11, 2011
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17611 NV Primary
Pharmacist 183500000X S017675 AZ

Addresses

Primary practice location

4090 W Craig Rd Ste 101
North Las Vegas, NV 89032-2758

Mailing address

PO Box 777833
Henderson, NV 89077-7833
Phone (702) 636-2054

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

LicenseStateTypeSpecialty
S017675AZMDPharmacist
17611NVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tango, Inc Current Accepting new patients
Tango, Inc Current Accepting new patients

Locations

4090 W Craig Rd
Ste 101
North Las Vegas, NV 89032
Phone (702) 636-2054

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": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1962781633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777833",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890777833",
            "telephone_number": "702-636-2054",
            "fax_number": "702-636-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4090 W CRAIG RD STE 101",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890322758",
            "telephone_number": "702-636-2054",
            "fax_number": "702-636-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APIBO-TANGO",
        "first_name": "ROBENSON",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-11",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "17611",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S017675",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.

Verify at the official NPI Registry.