Antonious Jonah Abraham, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

58382 Issued in CA

Practice address

246 W College St FL 3
Covina, CA 91723-1910

Phone

(626) 915-1911

Fax

(626) 915-2668

NPI assigned

Jul 13, 2020

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derm Lounge PCGroup PAC ID 9133666514, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aabraham670657@direct.memorialcare.org

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.

• Derm Lounge PC

  dba Derm Lounge

  • Dermatology Physician
  • Anaheim, CA
  • NPI 1962260208
  Medicare reassignment Care Compare group
• Alp Medical Services PC

  • Family Medicine Physician
  • Irvine, CA
  • NPI 1518854629
  Medicare reassignment NPD
• Pure Mobile Health Inc.

  • Clinic/Center
  • Glendale, CA
  • NPI 1194606673
  Medicare reassignment NPD
• Wound Care Solutions of California

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1023813615
  Medicare reassignment NPD
• Alphacell Wound Care, PC

  • Nurse Practitioner
  • North Hollywood, CA
  • NPI 1326883505
  Medicare reassignment
• Expert Wound Care PC

  dba Wound Experts

  • Surgery Physician
  • Pasadena, CA
  • NPI 1477445294
  Medicare reassignment
• Ocean Skin and Vein Institute

  • Dermatology Physician
  • Tustin, CA
  • NPI 1790246841
  Medicare reassignment
• Sun Medical Group, Inc

  dba AFC Ladera RAnch

  • Urgent Care Clinic/Center
  • Ladera Ranch, CA
  • NPI 1114588704
  Medicare reassignment
• A.M. Wound Care Corporation

  • Multi-Specialty Clinic/Center
  • Irvine, CA
  • NPI 1245056738
  NPD (past) Authorized official
• DM Laser and Derma Center

  • Dermatology Physician
  • Covina, CA
  • NPI 1164287066
  NPD
• Sun Medical Group, Inc.

  dba AFC Urgent Care Anaheim

  • Urgent Care Clinic/Center
  • Anaheim, CA
  • NPI 1114673902
  NPD

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1003434275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 N STATE COLLEGE BLVD APT 3068",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928685724",
            "telephone_number": "978-325-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 W COLLEGE ST FL 3",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231910",
            "telephone_number": "626-915-1911",
            "fax_number": "626-915-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "ANTONIOUS",
        "middle_name": "JONAH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-13",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "58382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bolton",
            "affiliation": "N",
            "address_1": "99 Corn Rd",
            "city": "Bolton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017401055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abaworks LLC.
• Abbassi Johnson Professional Corporation (N/a)
• Samera Lizette Abdelrhman
• Christopher Alan Abernathy
• Paul Michael Corpus Abesamis
• Tsige Abram
• Absolute Patient Sitter Staffing Services
• Absolute Senior Care Services, Inc
• Mary Gamil Absood, M.D.
• Access Medical Transport Corp

• Medical Physician Assistant in Covina, CA
• Providers in Covina, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.