Individual provider Active NPI

James M. Abraham, O. D.

  • Optometrist
  • Murray, UT
National Provider Identifier
1063597342
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
931122779934 Issued in UT
Practice address
4995 Atwood Blvd
Murray, UT 84107-4964
Phone
(801) 288-0882
Fax
(801) 288-0977
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 931122779934 UT Primary

Addresses

Primary practice location

4995 Atwood Blvd
Murray, UT 84107-4964

Mailing address

4995 Atwood Blvd
Murray, UT 84107-4964
Phone (801) 288-0882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031227000021 UT Practitioner - Optometry 3476451527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7677 S Maple St
Midvale, UT 84047-7392
Phone (801) 288-0882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
931122779934UTMDOptometrist

Practice roles (2 of 4)

OrganizationSpecialtyStatusNew patients
Advantage Eye Care , P. C. CurrentSince Jun 2, 2011 Accepting new patients
Advantage Eye Care , P. C. CurrentSince Jun 2, 2011 Accepting new patients

Locations

7677 S Maple St
Midvale, UT 84047
Phone (801) 288-0882

538 S State St
Orem, UT 84058
Phone (801) 373-1711

394 E University Pkwy
Orem, UT 84058
Phone (801) 373-1711

4995 S Atwood Blvd
Salt Lake City, UT 84107
Phone (801) 288-0882

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1063597342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 ATWOOD BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074964",
            "telephone_number": "801-288-0882",
            "fax_number": "801-288-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 ATWOOD BLVD",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074964",
            "telephone_number": "801-288-0882",
            "fax_number": "801-288-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "931122779934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.