Individual provider Active NPI

Abraham Joseph Kiesel, PA-C

  • Medical Physician Assistant
  • Evansville, IN
National Provider Identifier
1699504415
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10004516A Issued in IN
Practice address
520 Mary St Ste 520
Evansville, IN 47710-1682
Phone
(812) 424-8231
Fax
(812) 435-8794
NPI assigned
Jul 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10004516A IN Primary

Addresses

Primary practice location

520 Mary St Ste 520
Evansville, IN 47710-1682

Mailing address

520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231

Other practice location 1

4133 Gateway Blvd Ste 290
Newburgh, IN 47630-7918
Phone (812) 424-8231

Other practice location 2

801 Saint Marys Dr Ste 200E
Evansville, IN 47714-0518
Phone (812) 424-8231

Other identifiers 4

IdentifierTypeStateIssuer
1222091OtherINBOARD CERTIFICATION
10004516AOtherININDIANA LICENSE
300096298MedicaidIN
7101011410MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918001903 IN Practitioner - Physician Assistant 5496296436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Clinic IncGroup PAC ID 3375610116, 411 clinicians
Evansville Surgical Associates IncGroup PAC ID 1557346723, 45 clinicians

Practice addresses (Care Compare)

1414 W Broadway St
Deaconess Clinic Urgent Care Princeton
Princeton, IN 47670-1142
Phone (812) 385-5283

4011 Gateway Blvd
Newburgh, IN 47630-8947
Phone (812) 424-8231

520 Mary St
Suite 520
Evansville, IN 47710-1669

520 Mary St
Suite 520
Evansville, IN 47710-1682
Phone (812) 424-8231

600 Mary St
Evansville, IN 47710-1658
Phone (812) 424-8231

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc CurrentSince Oct 6, 2025 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic, Inc. CurrentSince Oct 6, 2025 Accepting new patients
Deaconess Clinic, Inc Past Accepting new patients

Locations

3150 Warrick Dr
Boonville, IN 47601
Phone (812) 450-6430

4506 N 1st Ave
Evansville, IN 47710
Phone (812) 428-6161

2622 Menards Dr
Evansville, IN 47715
Phone (812) 450-2622

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264

120 SE 4th St
Evansville, IN 47708
Phone (812) 426-6638

4011 Gateway Blvd
Ste 100
Newburgh, IN 47630
Phone (812) 858-2100

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

4199 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-4200

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1414 W Broadway St
Princeton, IN 47670
Phone (812) 385-5283

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784851200000",
    "number": "1699504415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST STE 520",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101682",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4133 Gateway Blvd Ste 290",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307918",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "801 Saint Marys Dr Ste 200E",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477140518",
            "country_code": "US",
            "telephone_number": "812-424-8231",
            "fax_number": "812-435-8794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIESEL",
        "first_name": "ABRAHAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10004516A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFICATION",
            "identifier": "1222091",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE",
            "identifier": "10004516A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300096298",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7101011410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.