Elsamma Abraham, ANP
Individual provider Active NPI Nurse Practitioner · New York, NY
NPI 1043461668 · NPPES record last updated Jul 30, 2015
Key facts
- NPI
- 1043461668
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 304477-1 (NY)
- Practice address
- 1 Penn PLZ
8TH Floor
New York, NY 10119-0002 - Phone
- (646) 627-3803
- NPI assigned
- Oct 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102001932 | NY | Order and Referring Only - Nurse Practitioner | 7911064498 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 304477-1 | NY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Avenue Medical Associates, P.C. | Past |
Accepting new patients | |
| Lifespire, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 304477-1 | NY | Yes |
Addresses
Primary practice location
1 Penn PLZ
8TH Floor
New York, NY 10119-0002
Mailing address
1 Penn PLZ
8TH Floor
New York, NY 10119-0002
Other providers in New York, NY
- Bessy N Abraham
- Bincy Abraham
- Bracha Yaffa Abraham
- Daniella Abraham
- Danielle Rebecca Abraham
- Feby Ann Abraham
- Heather Abraham
- Irwin Abraham
- Jesa Abraham
- Jessica Lynn Abraham
All providers in New York, NY · Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.