Individual provider Active NPI

Jesa Abraham, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1417660804
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
029271 Issued in NY
Practice address
30 7TH Ave
New York, NY 10011-6629
Phone
(646) 665-6900
NPI assigned
Dec 30, 2022
Last updated
Dec 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 029271 NY Primary
Emergency Medicine Physician 207P00000X 029271 NY

Addresses

Primary practice location

30 7TH Ave
New York, NY 10011-6629

Mailing address

600 Community Dr
Manhasset, NY 11030-3802

Other practice location 1

101 Hospital Rd
Patchogue, NY 11772-4870
Phone (631) 654-7100

Other practice location 2

270-5 76th Avenue
Queens, NY 11040
Phone (718) 470-7501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230419001314 NY Practitioner - Physician Assistant 5092180364 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC Emergency Medicine CurrentSince Mar 30, 2023 Accepting new patients
New York University CurrentSince Feb 1, 2025 Accepting new patients
John T. Mather Memorial Hospital Emergency Medicine CurrentSince Apr 24, 2023 Accepting new patients
New York University Emergency Medicine CurrentSince Feb 1, 2025 Accepting new patients
John T. Mather Memorial Hospital CurrentSince Apr 24, 2023 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

300 Community Dr
Manhasset, NY 11030

30 7th Ave
New York, NY 10011
Phone (646) 665-6000

27005 76th Ave
North New Hyde Pk, NY 11040

101 Hospital Rd
Patchogue, NY 11772
Phone (631) 654-7100

75 N Country Rd
Prt Jefferson, NY 11777
Phone (631) 463-1320

900 Franklin Ave
Valley Stream, NY 11580
Phone (516) 256-6000

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: jabraham481254@nyumc.direct-ci.com

Organizations & group practices 6

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": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1417660804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 COMMUNITY DR",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 7TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116629",
            "telephone_number": "646-665-6900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Patchogue",
            "state": "NY",
            "postal_code": "117724870",
            "country_code": "US",
            "telephone_number": "631-654-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "270-5 76th Avenue",
            "address_purpose": "LOCATION",
            "city": "Queens",
            "state": "NY",
            "postal_code": "11040",
            "country_code": "US",
            "telephone_number": "718-470-7501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JESA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-30",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "029271",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "029271",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.