NPIMap

Individual provider Active NPI

Mohan Abraham, MD

  • Nephrology Physician
  • Royal Palm Beach, FL
National Provider Identifier
1740266592
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME83538 Issued in FL
Practice address
11301 Okeechobee Blvd
Ste 5a
Royal Palm Beach, FL 33411-8719
Phone
(561) 283-0384
Fax
(561) 282-3238
NPI assigned
Dec 22, 2005
Last updated
Apr 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME83538 FL Primary

Addresses

Primary practice location

11301 Okeechobee Blvd
Ste 5a
Royal Palm Beach, FL 33411-8719

Mailing address

11301 Okeechobee Blvd
Suite 5a,
Royal Palm Beach, FL 33411-8719
Phone (561) 283-0384

Other identifiers 1

IdentifierTypeStateIssuer
262702700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050425000780 FL Practitioner - NephrologyPractitioner - Internal Medicine 7315985959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Specialists of the Palm Beaches LLCGroup PAC ID 4880632421, 5 clinicians

Practice addresses (Care Compare)

11301 Okeechobee Blvd
5A
Royal Palm Beach, FL 33411-8719
Phone (561) 868-4846

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Specialists of the Palm Beaches LLC CurrentSince Jan 1, 2005 Accepting new patients

Locations

5887 Lake Worth Rd
Greenacres, FL 33463
Phone (561) 469-6502

11301 Okeechobee Blvd
Ste 5A
Royal Palm Beach, FL 33411
Phone (561) 283-0384

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mabraham274304@mhsdirect.net
  • Direct secure messaging: mohan.abraham@3079.securemail.prognocis.com

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.

Hospital & facility affiliations 8

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1740266592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 OKEECHOBEE BLVD",
            "address_2": "SUITE 5A,",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118719",
            "telephone_number": "561-283-0384",
            "fax_number": "561-282-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 OKEECHOBEE BLVD",
            "address_2": "STE 5A",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118719",
            "telephone_number": "561-283-0384",
            "fax_number": "561-282-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "MOHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME83538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262702700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.