NPIMap

Individual provider Active NPI

Tiffany M Abrahamian, DO

  • Emergency Medicine Physician
  • Duluth, MN
National Provider Identifier
1447601562
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
68212 Issued in MN
Practice address
407 E 3Rd St
Duluth, MN 55805-1950
Phone
(218) 786-8364
NPI assigned
Jun 29, 2016
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 68212 MN Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 74059-21 WI
Emergency Medicine Physician 207P00000X 5101022642 MI

Addresses

Primary practice location

407 E 3Rd St
Duluth, MN 55805-1950

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201006000068 MN Practitioner - Emergency Medicine 7315290889 Reassigns benefits to 10 organizations
I20201006002639 WI Practitioner - Emergency Medicine 7315290889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Polinsky Medical Rehabilitation CenterGroup PAC ID 0941377360, 369 clinicians
Essentia Health Virginia LLCGroup PAC ID 7810149002, 64 clinicians

Practice addresses (Care Compare)

1600 Miller Trunk Hwy
Duluth, MN 55811-5640
Phone (218) 786-5360

901 9TH St N
Virginia, MN 55792-2325
Phone (218) 741-3340

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
74059-21WIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Medical Center CurrentSince Sep 26, 2020 Accepting new patients
Essentia Health Virginia, LLC CurrentSince Sep 26, 2020 Accepting new patients
St. Mary's Hospital of Superior Current Accepting new patients
Essentia Health Moose Lake CurrentSince Oct 1, 2020 Accepting new patients
St. Mary's Duluth Clinic Health System Current Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Sep 26, 2020 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
Essentia Health Moose Lake CurrentSince Oct 1, 2020 Accepting new patients
Northern Pines Medical Center CurrentSince Sep 26, 2020 Accepting new patients
Pine Medical Center CurrentSince Sep 26, 2020 Accepting new patients
St Marys Medical Center Current Accepting new patients
Deer River Healthcare Center, Inc CurrentSince Sep 26, 2020 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Sep 18, 2020 Accepting new patients
Northern Pines Medical Center CurrentSince Jan 1, 2026 Accepting new patients
Pine Medical Center CurrentSince Sep 26, 2020 Accepting new patients
St. Mary's Medical Center CurrentSince Sep 26, 2020 Accepting new patients
Northern Pines Medical Center CurrentSince Sep 26, 2020 Accepting new patients
Moose Lake Community Hospital District Current Accepting new patients

Locations

5211 Highway 110
Aurora, MN 55705
Phone (218) 229-1010

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

402 E 2nd St
Duluth, MN 55805
Phone (218) 786-3443

407 E 3rd St
Duluth, MN 55805
Phone (218) 786-4357

4572 County Road 61
Moose Lake, MN 55767
Phone (218) 485-4481

705 Lundorff Dr
Sandstone, MN 55072
Phone (320) 245-2211

901 9th St N
Virginia, MN 55792
Phone (218) 741-3340

1702 University Dr S
Fargo, ND 58103
Phone (701) 364-4222

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1447601562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051950",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAMIAN",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "68212",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "74059-21",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.