NPIMap

Individual provider Active NPI

David Pothen Abraham, DO

  • Internal Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1215565692
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP61416743 Issued in WA
Practice address
1801 E Division St
Mount Vernon, WA 98274-4632
Phone
(360) 424-4410
Fax
(360) 424-0749
NPI assigned
Mar 31, 2020
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OP61416743 WA Primary

Addresses

Primary practice location

1801 E Division St
Mount Vernon, WA 98274-4632

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dabraham60785@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20230809002774 WA Practitioner - Internal Medicine 3678935509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

110 N Laventure Rd
Suite C
Mount Vernon, WA 98273-3901
Phone (360) 399-7700

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

1801 E Division St
Mount Vernon, WA 98274-4632
Phone (360) 424-4410

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 18, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 18, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1801 E Division St
Mount Vernon, WA 98274
Phone (360) 424-4410

Interoperability endpoints

  • Direct secure messaging: dabraham60785@skagit.direct-ci.com

Organizations & group practices 3

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 11

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1215565692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E DIVISION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744632",
            "telephone_number": "360-424-4410",
            "fax_number": "360-424-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "DAVID",
        "middle_name": "POTHEN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP61416743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dabraham60785@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1801 E Division St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.