Active NPI
Abby Cohen, MD
- Family Medicine Physician
- South Lake Tahoe, CA
National Provider Identifier
1336221548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G27971
- Practice address
- 2155 South Ave
#25-A
South Lake Tahoe, CA 96158 - Phone
- (530) 541-3286
- Fax
- (530) 541-2005
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G27971 | CA | Primary |
Addresses
Primary practice location
2155 South Ave
#25-A
South Lake Tahoe, CA 96158
Mailing address
PO Box 7530
2155 South Ave #25-a
South Lake Tahoe, CA 96158
Phone (530) 541-3286
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G27971 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abby Cohen MD a Medical Corporation | Family Medicine | 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 and National Provider Directory roles.
-
- Family Medicine Physician
- South Lake Tahoe, CA
- NPI 1013140177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185408000000",
"number": "1336221548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7530",
"address_2": "2155 SOUTH AVE #25-A",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "96158",
"telephone_number": "530-541-3286",
"fax_number": "530-541-2005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 SOUTH AVE",
"address_2": "#25-A",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "96158",
"telephone_number": "530-541-3286",
"fax_number": "530-541-2005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COHEN",
"first_name": "ABBY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G27971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.