Organization Active NPI

Matthew Mack Abraham, LLC

  • Sleep Medicine (Internal Medicine) Physician
  • Lafayette, LA
National Provider Identifier
1548314495
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
MD024082 Issued in LA
Legal business name
MATTHEW MACK ABRAHAM, LLC
Practice address
100 Asma Blvd
BLDG One, Ste 205
Lafayette, LA 70508-3858
Phone
(337) 289-5605
Fax
(337) 289-5609
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Matthew Mack Abraham, M.D.NPI 1174511794
Title
Owner
Phone
(337) 289-5605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0012X MD024082 LA Primary

Addresses

Primary practice location

100 Asma Blvd
BLDG One, Ste 205
Lafayette, LA 70508-3858

Mailing address

100 Asma Blvd
BLDG One, Ste 205
Lafayette, LA 70508-3858
Phone (337) 289-5605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060123000623 LA Part B Supplier - Clinic/Group Practice 3779507397 Receives reassigned benefits from 1 practitioner
Practice locations: Crowley, LA; Lafayette, LA

National Provider Directory

National Provider Directory

Locations

100 Asma Blvd
Lafayette, LA 70508
Phone (337) 456-7880

100 Asma Blvd
Bldg 1
Lafayette, LA 70508
Phone (337) 289-5605

2701 Johnston St
Ste 100
Lafayette, LA 70503
Phone (337) 261-2633

106 Westmark Blvd
Ste 107
Lafayette, LA 70506
Phone (337) 406-0712

2612 Severn Ave
Ste E
Metairie, LA 70002

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548314495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ASMA BLVD",
            "address_2": "BLDG ONE, STE 205",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083858",
            "telephone_number": "337-289-5605",
            "fax_number": "337-289-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ASMA BLVD",
            "address_2": "BLDG ONE, STE 205",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083858",
            "telephone_number": "337-289-5605",
            "fax_number": "337-289-5609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW MACK ABRAHAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "MACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-289-5605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "LA",
            "license": "MD024082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.