Individual provider Active NPI

Gerard Walter Abrahamsen, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1407800790
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008178 Issued in NY
Practice address
485 Madison Ave FL 8
New York, NY 10022-5803
Phone
(212) 883-8868
Fax
(212) 883-8886
NPI assigned
May 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00076600 NJ
Physician Assistant 363A00000X 008178 NY Primary
Medical Physician Assistant 363AM0700X 008178 NY

Addresses

Primary practice location

485 Madison Ave FL 8
New York, NY 10022-5803

Mailing address

1073 Rensselaer Ave
Staten Island, NY 10309
Phone (917) 612-2418

Other practice location 1

115 E 57th St
Ste 610
New York, NY 10022-2049
Phone (212) 535-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090930000408 NJ Practitioner - Physician Assistant 9234275587 Reassigns benefits to 1 organization
I20091013000688 NY Practitioner - Physician Assistant 9234275587 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kayal Medical Group, LLCGroup PAC ID 2961894019, 76 clinicians

Practice addresses (Care Compare)

260 Old Hook Rd
Suite 401
Westwood, NJ 07675-3123
Phone (844) 777-0910

266 Harristown Rd
Glen Rock, NJ 07452-3321
Phone (844) 777-0910

543 45TH St
Union City, NJ 07087-2615
Phone (844) 777-0910

784 Franklin Ave
Franklin Lakes, NJ 07417-1306
Phone (844) 777-0910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
008178NYMDOptometrist

Interoperability endpoints

  • Direct secure messaging: gabrahamsen576071@ahs.direct-ci.com

Organizations & group practices 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407800790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 RENSSELAER AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10309",
            "telephone_number": "917-612-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 MADISON AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225803",
            "telephone_number": "212-883-8868",
            "fax_number": "212-883-8886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 E 57th St",
            "address_2": "Ste 610",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100222049",
            "country_code": "US",
            "telephone_number": "212-535-3505",
            "fax_number": "212-535-3568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAMSEN",
        "first_name": "GERARD",
        "middle_name": "WALTER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00076600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008178",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008178",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.