Individual provider Active NPI

Abigail Obrien, FNP

  • Pediatrics Physician
  • Boca Raton, FL
National Provider Identifier
1750015418
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
APRN11020592 Issued in FL
Practice address
5458 Town Center Rd Ste 20
Boca Raton, FL 33486-1009
Phone
(561) 391-6210
NPI assigned
Jul 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN11020592 FL Primary

Addresses

Primary practice location

5458 Town Center Rd Ste 20
Boca Raton, FL 33486-1009

Mailing address

932 Westholm Rd
Niskayuna, NY 12309-6518
Phone (518) 728-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250312001172 MA Practitioner - Nurse Practitioner 5597286195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11020592FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mattapan Community Health Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657411200000",
    "number": "1750015418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 WESTHOLM RD",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "123096518",
            "telephone_number": "518-728-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5458 TOWN CENTER RD STE 20",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334861009",
            "telephone_number": "561-391-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "ABIGAIL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-10",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "APRN11020592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.