Charles G Abraham, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

LDR180202 Issued in IN

Practice address

550 University Blvd # Uh3195
Indianapolis, IN 46202

Phone

(317) 274-8300

Fax

(317) 274-8300

NPI assigned

Jun 20, 2017

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 1, 2023 through Nov 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• IL HMO C-SNP
• KY PPO C-SNP
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6

Interoperability endpoints

• Direct secure messaging: cabraham4@direct.iuhealth.org
• FHIR API: https://api.platform.athenahealth.com/8479/brand/1/csg/1/fhir/r4

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.

• Bloomington Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Bloomington, IN
  • NPI 1891350575
  NPD (past)
• Indiana University

  dba Indiana University School of Dentistry

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552
  NPD (past)

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1003336249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 DENTAL SCIENCE BLDG S",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421001",
            "telephone_number": "319-335-7440",
            "fax_number": "319-335-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD # UH3195",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-274-8300",
            "fax_number": "317-274-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "CHARLES",
        "middle_name": "G",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "09397",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "LDR180202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abounding Joy Counseling & Wellness Services
• Above & Beyond Homecare Services
• Above and Beyond Services Inc.
• Steven Abragan
• Bindu C Abraham
• Olivia Carter Abraham, MD
• Tanya Mary Abraham, M.D.
• Vinu Simon Abraham, M.D.
• Melanie Abrahams
• Abram Sinn Ma MFT LLC

• Oral and Maxillofacial Surgery (Dentist) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.