Individual provider Active NPI

Kenneth J Abrams, MD, MBA

  • Anesthesiology Physician
  • Pomona, NJ
National Provider Identifier
1306881644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07702300 Issued in NJ
Practice address
65 Jimmie Leeds Road
Department of Anesthesiology and Perioperative Medicine
Pomona, NJ 08240
Phone
(609) 748-7597
NPI assigned
Jun 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07702300 NJ Primary

Addresses

Primary practice location

65 Jimmie Leeds Road
Department of Anesthesiology and Perioperative Medicine
Pomona, NJ 08240

Mailing address

39 Brush Hill Rd
Kinnelon, NJ 07405-2422

Other identifiers 1

IdentifierTypeStateIssuer
0048771MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07702300NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Regional Medical Center Anesthesiology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306881644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BRUSH HILL RD",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JIMMIE LEEDS ROAD",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY AND PERIOPERATIVE MEDICINE",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "08240",
            "telephone_number": "609-748-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "KENNETH",
        "middle_name": "J",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07702300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048771",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.