Ronnie M Abraham, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · San Luis Obispo, CA
NPI 1124254933 · NPPES record last updated Jan 19, 2019
Key facts
- NPI
- 1124254933
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- C159083 (CA)
- Practice address
- 3440 Empresa Dr Ste B
San Luis Obispo, CA 93401 - Phone
- (805) 548-1550
- Fax
- (805) 623-1595
- NPI assigned
- Jun 8, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- Jefferson Medical College of Thomas Jefferson University, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1885 FM
2673 Unit 146
Canyon Lake, TX 78133
645 Gravois Bluffs Blvd
Suite E
Fenton, MO 63026-7715
PO Box
Suite 3160
San Luis Obispo, CA 93403
Hospital & facility affiliations
- Saint John'S Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C159083 | CA | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Saint John'S Health Center | Current | Accepting new patients |
Locations
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | C159083 | CA | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | C159083 | CA | Yes |
Addresses
Primary practice location
3440 Empresa Dr Ste B
San Luis Obispo, CA 93401
Mailing address
PO Box 3160
San Luis Obispo, CA 93403-3160
Phone (805) 548-1550
Other providers in San Luis Obispo, CA
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- Able Therapy Services
- Abroms Dougherty Vision ASC LLC
- Mona Abutouk
- Achilles Prosthetics and Orthotics, Inc
- Laurence Ackerman
- Adam J. Janette, DDS Inc.
All providers in San Luis Obispo, CA · Anatomic Pathology & Clinical Pathology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2019. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.