Individual provider Active NPI

Abbesalom P Ghermay, MD

  • Specialist
  • Plano, TX
National Provider Identifier
1487624755
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
L3656 Issued in TX
Practice address
6101 W Plano Pkwy Ste 100
Plano, TX 75093-8201
Phone
(214) 750-3646
NPI assigned
Jan 26, 2006
Last updated
Jan 25, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L3656 TX Primary

Addresses

Primary practice location

6101 W Plano Pkwy Ste 100
Plano, TX 75093-8201

Mailing address

6101 W Plano Pkwy Ste 100
Plano, TX 75093-8201
Phone (214) 750-3646

Other identifiers 1

IdentifierTypeStateIssuer
152433104MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050316000262 TX Practitioner - AnesthesiologyPractitioner - Pain Management 8527013267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
University of California, San Francisco School of Medicine, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Dallas Neurosurgical Associates PAGroup PAC ID 1254386907, 15 clinicians

Practice addresses (Care Compare)

6101 W Plano Pkwy
Suite 100
Plano, TX 75093-8201
Phone (214) 750-3646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L3656TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Neurosurgical Associates, P.a. Specialist CurrentSince Apr 4, 2005 Accepting new patients
North Texas Anesthesia Consultants, PA PastSince Jan 1, 2003 Accepting new patients

Locations

7515 Greenville Ave
Ste 200
Dallas, TX 75231
Phone (214) 445-6970

8230 Walnut Hill Ln
Ste 220
Dallas, TX 75231
Phone (214) 345-8692

6101 W Plano Pkwy
Ste 100
Plano, TX 75093
Phone (214) 750-3646

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1487624755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 W PLANO PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938201",
            "telephone_number": "214-750-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 W PLANO PKWY STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938201",
            "telephone_number": "214-750-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHERMAY",
        "first_name": "ABBESALOM",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L3656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152433104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.