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Dr. Blake Rufus Mangum , PharmD

Pharmacist β€’ New Haven, CT

Active NPI 1821827254 Individual Practitioner Male Practitioner
Practice location in NPPES

55 Park St
New Haven, CT 065115474

Call 2036884242 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

55 Park St

New Haven, CT 065115474

Telephone 2036884242
Organization at the Same NPPES Address or Phone
Yale New Haven Hospital Facility NPI 1003519331

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in New Haven and Connecticut

276 active clinicians are listed under Pharmacist with a practice address in New Haven, CT (3,248 in Connecticut).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in New Haven

0% of these 276 clinicians have the CMS telehealth indicator.

0% of these 276 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-09-27
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

License # reported to NPPES CT PCT.0016818

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NUCC Taxonomy Code: 1835P0018X

License # reported to NPPES MS E-100727

Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Connecticut Department of Public Health Verification.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

20 listed
NPI 1013496553

Doctor of Medicine (M.D.), Master of Public Health

Joshua Bia

Emergency Medicine

NPI 1003435207
Giorgio Caturegli

Student in an Organized Health Care Education/Training Program

NPI 1013552090
Dr. Isaac Chan , MD

Student in an Organized Health Care Education/Training Program

NPI 1013602549

Doctor of Medicine (M.D.)

Christopher El Mouhayyar

Internal Medicine

NPI 1003476227
Dr. Nathan Johnson , MD, PhD

Student in an Organized Health Care Education/Training Program

NPI 1013650423

Doctor of Medicine (M.D.), Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 27, 2024

Pharmacist (license number reported to NPPES: CT PCT.0016818)

βœ…
NPI Profile Active August 01, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 01, 2024

Registered at 55 PARK ST, NEW HAVEN, CT 065115474 (Tel: 2036884242)

πŸ“
Business Mailing Address (Initial Record) August 01, 2024

Registered at 55 PARK ST, NEW HAVEN, CT 065115474

πŸ‘€
Provider Name / Credentials (Initial Record) August 01, 2024

Recorded as BLAKE MANGUM, PHARMD

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 01, 2024

Pharmacist (license number reported to NPPES: MS E-100727)

🟒
Initial NPI Registration & Enumeration August 01, 2024

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1821827254
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 01, 2024
Last Update: September 27, 2024
Sole Proprietor: Yes

Other Pharmacists in New Haven

All Pharmacists in New Haven

Mailing Address

55 Park St

New Haven, CT 065115474

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.