Iype Abraham, M.D.
Individual provider Active NPI Internal Medicine Physician · Santa Clara, CA
NPI 1578737243 · NPPES record last updated Feb 11, 2022
Key facts
- NPI
- 1578737243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A103223 (CA)
- Practice address
- 710 Lawrence Expy
Dept. 260
Santa Clara, CA 95051-5173 - Phone
- (408) 851-2005
- Fax
- (408) 851-2275
- NPI assigned
- Apr 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081021000552 | CA | Practitioner - Internal Medicine | 5890853758 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A103223 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Permanente Medical Group, Inc | Current |
Accepting new patients | |
| Permanente Medical Group Inc | Internal Medicine | Current |
Accepting new patients |
| Permanente Medical Group Inc | Internal Medicine | Current | Accepting new patients |
Locations
1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500
2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000
250 Hospital Pkwy
San Jose, CA 95119
Phone (408) 972-6320
710 Lawrence Expy
#260
Santa Clara, CA 95051
Phone (408) 236-5814
710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400
7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000
975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A103223 | CA | Yes |
Addresses
Primary practice location
710 Lawrence Expy
Dept. 260
Santa Clara, CA 95051-5173
Mailing address
710 Lawrence Expy
Dept. 260
Santa Clara, CA 95051-5173
Phone (732) 861-1275
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Other providers in Santa Clara, CA
- Abiy Transportation Services LLC
- Kenneth Ablao
- Abode Services
- Janely Abootorabi
- Akasha Liu Abraham
- Oren N. Abramson
- Kasey Abshier
- Nader Achackzad
- Achievekids
- Acm Services
All providers in Santa Clara, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2022. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.