Individual provider Active NPI

Dennrik Abrahan, M.D.

  • Pediatric Critical Care Medicine Physician
  • Tampa, FL
National Provider Identifier
1194143115
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME144449 Issued in FL
Practice address
17 Davis Blvd
Suite 308
Tampa, FL 33606-3475
Phone
(813) 250-2506
NPI assigned
Apr 7, 2014
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME144449 FL Primary

Addresses

Primary practice location

17 Davis Blvd
Suite 308
Tampa, FL 33606-3475

Mailing address

1033 Dr Martin Luther King St N Ste 108
St Petersburg, FL 33701-1547
Phone (727) 865-4290

Other identifiers 2

IdentifierTypeStateIssuer
106524700MedicaidFL
B44B7OtherFLBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dabrahan100500@direct.tgh.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220211000264 FL Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 5890065221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pediatric Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jan 25, 2022 Accepting new patients
University Medical Service Association Inc CurrentSince Jan 25, 2022 Accepting new patients
Hospital Physician Services of Florida PA CurrentSince Mar 14, 2025 Accepting new patients
The Metrohealth System Current Accepting new patients
University Medical Service Association Inc Current Accepting new patients

Locations

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Interoperability endpoints

  • Direct secure messaging: dabrahan137897@direct.metrohealth.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

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 1

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": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1194143115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 DR MARTIN LUTHER KING ST N STE 108",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011547",
            "telephone_number": "727-865-4290",
            "fax_number": "727-346-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DAVIS BLVD",
            "address_2": "SUITE 308",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063475",
            "telephone_number": "813-250-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAN",
        "first_name": "DENNRIK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-07",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME144449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106524700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "B44B7",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dabrahan100500@direct.tgh.org",
            "affiliation": "N",
            "address_1": "17 Davis Blvd",
            "address_2": "Suite 308",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336063475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.