NPIMap

Individual provider Active NPI

Julia Agnes Abraham, PA-C

  • Physician Assistant
  • Dell Rapids, SD
National Provider Identifier
1104082288
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0684 Issued in SD
Practice address
111 E 10TH St
Dell Rapids, SD 57022-1217
Phone
(605) 428-5446
Fax
(605) 428-2333
NPI assigned
Jul 29, 2008
Last updated
Oct 22, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0684 SD Primary

Addresses

Primary practice location

111 E 10TH St
Dell Rapids, SD 57022-1217

Mailing address

111 E 10TH St
Dell Rapids, SD 57022-1217
Phone (605) 428-5446

Other identifiers 4

IdentifierTypeStateIssuer
6829852MedicaidSD
6829854MedicaidSD
6829850MedicaidSD
6829853MedicaidSD

Other names 1

  • Julia Agnes Vermeer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000103 SD Practitioner - Physician Assistant 9739257064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0684SDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Apr 18, 2022 Accepting new patients
Rural Health Care, Inc CurrentSince Dec 14, 2009 Accepting new patients
Avera McKennan Past Accepting new patients
Rural Health Care, Inc. Past Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

200 Commercial Ave SE
Highmore, SD 57345
Phone (605) 852-2238

210 N Broadway Ave
Miller, SD 57362

Interoperability endpoints

  • Direct secure messaging: julia.abraham@avera.sdhealthlink.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1104082288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 10TH ST",
            "city": "DELL RAPIDS",
            "state": "SD",
            "postal_code": "570221217",
            "telephone_number": "605-428-5446",
            "fax_number": "605-428-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 10TH ST",
            "city": "DELL RAPIDS",
            "state": "SD",
            "postal_code": "570221217",
            "telephone_number": "605-428-5446",
            "fax_number": "605-428-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JULIA",
        "middle_name": "AGNES",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829852",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829854",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829850",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829853",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "VERMEER",
            "middle_name": "AGNES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dell Rapids, SD

Sources for this page

Verify at the official NPI Registry.