Active NPI
Abigail Lee Haberman, MD
- Dermatology Physician
- Corvallis, OR
National Provider Identifier
1255401063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD16039
- Practice address
- 690 NW Calloway Dr
Corvallis, OR 97330-9598 - Phone
- (541) 754-2757
- Fax
- (541) 754-3584
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | MD16039 | OR | Primary |
Addresses
Primary practice location
690 NW Calloway Dr
Corvallis, OR 97330-9598
Mailing address
690 NW Calloway Dr
Corvallis, OR 97330-9598
Phone (541) 754-2757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041181 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120508000256 | OR | Practitioner - Dermatology | 3476715582 | Practice locations: Corvallis, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Oregon Health Sciences University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
690 NW Calloway Dr
Corvallis, OR 97330-9598
Phone (541) 754-2757
Hospital & facility affiliations
- Ohsu Hospital and Clinics
- Good Samaritan Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 31 |
| Removal of skin lesions | 424 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 217 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- ahaberman91065@samhealth.direct-ci.com
Hospital & facility affiliations 22
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Corvallis, OR
- NPI 1134552003
Hospital
-
- Obstetrics & Gynecology Physician
- Corvallis, OR
- NPI 1275882102
Hospital
-
- Infectious Disease Physician
- Corvallis, OR
- NPI 1407112642
Hospital
-
- Gynecologic Oncology Physician
- Corvallis, OR
- NPI 1710787916
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1255401063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 NW CALLOWAY DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973309598",
"telephone_number": "541-754-2757",
"fax_number": "541-754-3584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 NW CALLOWAY DR",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973309598",
"telephone_number": "541-754-2757",
"fax_number": "541-754-3584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABERMAN",
"first_name": "ABIGAIL",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "OR",
"license": "MD16039",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041181",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.