Organization Active NPI

Abraham Owusu-Dommey LLC

  • Specialist
  • Gilbert, AZ
National Provider Identifier
1346284668
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26852 Issued in AZ
Legal business name
ABRAHAM OWUSU-DOMMEY LLC
Practice address
3303 S Lindsay Rd
Ste 123
Gilbert, AZ 85297-1503
Phone
(480) 821-9339
Fax
(480) 821-9555
NPI assigned
Jun 16, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Dr. Abraham Owusu Dommey, M.D.NPI 1457311367
Title
Owner
Phone
(480) 821-9339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 26852 AZ Primary

Addresses

Primary practice location

3303 S Lindsay Rd
Ste 123
Gilbert, AZ 85297-1503

Mailing address

PO Box 2510
Mesa, AZ 85214-2510
Phone (480) 821-9339

Other identifiers 1

IdentifierTypeStateIssuer
491176MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061109000637 AZ Part B Supplier - Clinic/Group Practice 4284632001 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ; Scottsdale, AZ; Gilbert, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1346284668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2510",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852142510",
            "telephone_number": "480-821-9339",
            "fax_number": "480-821-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 S LINDSAY RD",
            "address_2": "STE 123",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852971503",
            "telephone_number": "480-821-9339",
            "fax_number": "480-821-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAHAM OWUSU-DOMMEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "OWUSU DOMMEY",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-821-9339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "26852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "491176",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.