Jaeon Abraham, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

R1680 Issued in TX

Practice address

3105 W 15TH St Ste D
Plano, TX 75075-7700

Phone

(972) 867-2869

NPI assigned

Mar 29, 2014

Last updated

Mar 17, 2018By 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

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jabraham80413@direct.childrens.com

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.

• Dallas Physician Medical Services for Children Inc

  dba Children's Health Medical Group

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1194153650
  Medicare reassignment NPD
• Northside Pediatrics, PLLC

  • Pediatrics Physician
  • Plano, TX
  • NPI 1629784194
  NPD Authorized official
• Olive Branch Pediatrics, PLLC

  • Pediatrics Physician
  • Plano, TX
  • NPI 1659808723
  NPD Authorized official
• Dallas Physician Medical Services for Children Inc

  dba Children's Health Medical Group

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1558407908
  NPD
• Columbia Medical Center of Plano Subsidiary LP

  dba Medical City Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  NPD (past)
• Complex Care Medical Services Corporation

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1013256098
  NPD (past)

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

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1043638885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST STE D",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "972-867-2869",
            "fax_number": "972-964-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 W 15TH ST STE D",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757700",
            "telephone_number": "972-867-2869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1935 Medical District Dr",
            "address_2": "Graduate Medical Education",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752357701",
            "country_code": "US",
            "telephone_number": "214-456-2735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JAEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R1680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oluwatoyin Arike Abiodun, MD
• Constance Jean Abookire, LPC
• Ayat Alaa Aborahma, PA-C
• Benjamin Roshan Abraham, MD
• Christina Abraham
• Joselyn Abraham
• Michael Mathew Abraham
• Minija A Abraham, WHCNP
• Sheena Abraham
• Sindhu A Abraham, M.D.

• Pediatrics Physician in Plano, TX
• Providers in Plano, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.