Active NPI
Michael Abrishami, M.D.
- Dermatology Physician
- Indianapolis, IN
National Provider Identifier
1740307073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 01065989A
- Practice address
- 550 University Blvd # Uh3240
Indianapolis, IN 46202-5149 - Phone
- (317) 274-7705
- NPI assigned
- Mar 23, 2007
- Last updated
- Feb 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 243214 | NY | |
| Dermatology Physician | 207N00000X | BA9238610 | CA | |
| Dermatology Physician | 207N00000X | 01065989A | IN | Primary |
| MOHS-Micrographic Surgery Physician | 207ND0101X | 243214 | NY | |
| MOHS-Micrographic Surgery Physician | 207ND0101X | BA9238610 | CA | |
| Procedural Dermatology Physician | 207NS0135X | 243214 | NY | |
| Procedural Dermatology Physician | 207NS0135X | BA9238610 | CA |
Addresses
Primary practice location
550 University Blvd # Uh3240
Indianapolis, IN 46202-5149
Mailing address
607 N Maple Dr
Beverly Hills, CA 90210-3439
Phone (310) 499-7129
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
| License | State | Type | Specialty |
|---|---|---|---|
| 01065989A | IN | MD | Dermatology Physician |
| 243214 | NY | MD | MOHS-Micrographic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Dermatology, Inc. | Dermatology | Past | Accepting new patients |
| Goldman Dermatology, PLLC | Past | Accepting new patients |
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.
-
- Dermatology Physician
- Indianapolis, IN
- NPI 1033159405
-
- Specialist
- New York, NY
- NPI 1154311900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233792000000",
"number": "1740307073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 N MAPLE DR",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902103439",
"telephone_number": "310-499-7129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 UNIVERSITY BLVD # UH3240",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025149",
"telephone_number": "317-274-7705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABRISHAMI",
"first_name": "MICHAEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2009-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "243214",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "BA9238610",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "IN",
"license": "01065989A",
"primary": true
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "NY",
"license": "243214",
"primary": false
},
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "CA",
"license": "BA9238610",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "NY",
"license": "243214",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CA",
"license": "BA9238610",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.