Ann Abraham
Individual provider Active NPI Nurse Practitioner · Long Beach, CA
NPI 1447795182 · NPPES record last updated Nov 13, 2019
Key facts
- NPI
- 1447795182
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 95005144 (CA)
- Practice address
- 5190 Atlantic Ave
Long Beach, CA 90805-6510 - Phone
- (562) 428-4111
- Fax
- (562) 984-5461
- NPI assigned
- Jan 5, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tarzana Treatment Centers Inc
Practice addresses (Care Compare)
5190 Atlantic Ave
Long Beach, CA 90805-6510
Phone (800) 996-1051
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191007001016 | CA | Practitioner - Nurse Practitioner | 9335470376 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95005144 | CA | MD | Nurse Practitioner |
Practice roles (3 of 4)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tarzana Treatment Centers, Inc. | Current |
Accepting new patients | |
| Tarzana Treatment Centers, Inc. | Current | Accepting new patients | |
| Tarzana Treatment Centers, Inc. | Current |
Accepting new patients |
Locations
2101 Magnolia Ave
Long Beach, CA 90806
Phone (562) 218-1868
5190 Atlantic Ave
Long Beach, CA 90805
Phone (562) 428-4111
18646 Oxnard St
Tarzana, CA 91356
Phone (818) 654-3815
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- ann.abrahamnp.p1@direct.jwch.nextgenshare.com
- aabraham347155@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 95005144 | CA | |
| Nurse Practitioner | 363L00000X | 95005144 | CA | Yes |
Addresses
Primary practice location
5190 Atlantic Ave
Long Beach, CA 90805-6510
Mailing address
1750 Date Ave
Torrance, CA 90503-7210
Phone (310) 755-5103
Other providers in Long Beach, CA
- Tirsit Abiy
- Raymond Ables
- Cindy Aboud
- Saheil Samih Aboutalib
- Andrew Abraham
- Katherine Abraham
- Khadejah Abraham
- Gary Morris Abrahams
- Ashlee Abram
- Esmeralda Abril
All providers in Long Beach, CA · Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.