Individual provider Active NPI

Elizabeth Chathaparampil Abraham, M.D.

  • Pediatrics Physician
  • Saint Louis, MO
National Provider Identifier
1467654293
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2010013751 Issued in MO
Practice address
7387 Watson Rd Ste 310
Saint Louis, MO 63119-4405
Phone
(314) 500-5437
NPI assigned
Jun 4, 2007
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Emergency Response Attendant 146D00000X 57008703 OH
Pediatrics Physician 208000000X 2010013751 MO Primary
Pediatric Nephrology Physician 2080P0210X 57.008703 OH

Addresses

Primary practice location

7387 Watson Rd Ste 310
Saint Louis, MO 63119-4405

Mailing address

7387 Watson Rd Ste 310
Saint Louis, MO 63119-4405
Phone (314) 500-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address StTeresaPediatrics.ElizabethAbraham@140045.advancedmd-direct.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100915000998 MO Practitioner - NephrologyPractitioner - Pediatric Medicine 1355466244 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Pediatric Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7387 Watson Rd
Saint Louis, MO 63119-4405
Phone (314) 500-5437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57008703OHMDPersonal Emergency Response Attendant
2010013751MOMDPediatrics Physician
57.008703OHMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Gianna Pediatrics, LLC Pediatrics CurrentSince Feb 16, 2018 Accepting new patients
Great Mines Health Center CurrentSince Mar 20, 2020 Accepting new patients
Great Mines Health Center CurrentSince Mar 20, 2020 Accepting new patients

Locations

1 Southtowne Dr
Potosi, MO 63664
Phone (573) 438-8401

7387 Watson Rd
Saint Louis, MO 63119
Phone (314) 500-5437

7387 Watson Rd
Ste 310
Saint Louis, MO 63119
Phone (314) 500-5437

Interoperability endpoints

  • Direct secure messaging: stteresapediatrics.elizabethabraham@140045.advancedmd-direct.com

Organizations & group practices 3

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1467654293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7387 WATSON RD STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-500-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7387 WATSON RD STE 310",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631194405",
            "telephone_number": "314-500-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "ELIZABETH",
        "middle_name": "CHATHAPARAMPIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146D00000X",
            "taxonomy_group": "",
            "desc": "Personal Emergency Response Attendant",
            "state": "OH",
            "license": "57008703",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2010013751",
            "primary": true
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "OH",
            "license": "57.008703",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "StTeresaPediatrics.ElizabethAbraham@140045.advancedmd-direct.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "7387 Watson Rd Ste 310",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631194405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.