Individual provider Active NPI

Sheeja K. Abraham, MD

  • Pediatric Gastroenterology Physician
  • Philadelphia, PA
National Provider Identifier
1689759789
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD059230L Issued in PA
Practice address
1015 Chestnut Street Suite 601
Nemours Childrens Clinic, Philadelphia
Philadelphia, PA 19107-4306
Phone
(215) 503-2664
Fax
(215) 923-0459
NPI assigned
Oct 26, 2006
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MD059230L PA Primary

Addresses

Primary practice location

1015 Chestnut Street Suite 601
Nemours Childrens Clinic, Philadelphia
Philadelphia, PA 19107-4306

Mailing address

PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 5

IdentifierTypeStateIssuer
0001015701MedicaidDE
02714249MedicaidNY
7006802MedicaidNJ
001596077MedicaidPA
4097700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD059230LPAMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Past Accepting new patients
The Nemours Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sabraham11080@direct.nemours.org

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1689759789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHESTNUT STREET SUITE 601",
            "address_2": "NEMOURS CHILDRENS CLINIC, PHILADELPHIA",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074306",
            "telephone_number": "215-503-2664",
            "fax_number": "215-923-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "SHEEJA",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "PA",
            "license": "MD059230L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001015701",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02714249",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006802",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001596077",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4097700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.