Individual provider Active NPI

Ilona Abraham, MD

  • General Practice Physician
  • Encino, CA
National Provider Identifier
1700939576
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A25564 Issued in CA
Practice address
17815 Ventura Blvd
#111-113
Encino, CA 91316
Phone
(818) 345-8721
Fax
(818) 345-7150
NPI assigned
Jan 18, 2007
Last updated
Feb 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A25564 CA Primary

Addresses

Primary practice location

17815 Ventura Blvd
#111-113
Encino, CA 91316

Mailing address

17815 Ventura Blvd
Suite 111-113
Encino, CA 91316
Phone (818) 345-8721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20100311000650 CA Practitioner - General PracticePractitioner - Pain Management 3779618079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pain Management
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17815 Ventura Blvd
Suite 113
Encino, CA 91316-3629
Phone (818) 345-8721

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ilona Abraham MD Inc General Practice CurrentSince Jan 21, 2010 Accepting new patients

Locations

17815 Ventura Blvd
Ste 113
Encino, CA 91316
Phone (818) 345-8721

Organizations & group practices 1

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1700939576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17815 VENTURA BLVD",
            "address_2": "SUITE 111-113",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-345-8721",
            "fax_number": "818-345-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17815 VENTURA BLVD",
            "address_2": "#111-113",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91316",
            "telephone_number": "818-345-8721",
            "fax_number": "818-345-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "ILONA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A25564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.