Abba Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ABBA MEDICAL SUPPLY, INC.

Practice address

1900 S Main St Ste 108
Wake Forest, NC 27587-5027

Phone

(919) 263-9897

Fax

(919) 263-9828

NPI assigned

Feb 9, 2023

Organization subpart

No

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

Authorized official

Name

Suyapa Yesenia MartinezNPI 1386228104

Title

President

Phone

(919) 332-9578

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suyapa Yesenia Martinez, CFTS

  • Prosthetic/Orthotic Supplier
  • Raleigh, NC
  • NPI 1386228104
  NPD Authorized official

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1154028108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S MAIN ST STE 108",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875027",
            "telephone_number": "919-332-9578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S MAIN ST STE 108",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275875027",
            "telephone_number": "919-263-9897",
            "fax_number": "919-263-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBA MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "SUYAPA",
        "authorized_official_middle_name": "YESENIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-332-9578"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Wake Forest, NC
• Durable Medical Equipment & Medical Supplies in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.