Jerryl P Abraham, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Bronx, NY
NPI 1760125215 · NPPES record last updated Apr 13, 2022
Key facts
- NPI
- 1760125215
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (718) 920-5731
- NPI assigned
- Apr 13, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Albert Einstein College of Medicine of Yeshiva University, 2022
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Montefiore Medical Center
Practice addresses (Care Compare)
111 E 210TH St
Bronx, NY 10467-2401
Phone (866) 633-8255
Hospital & facility affiliations
- Montefiore Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250805000040 | NY | Practitioner - Internal Medicine | 4880102425 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (4 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current |
Accepting new patients | |
| Montefiore Medical Center | Current |
Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Montefiore Medical Center | Past | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Interoperability endpoints
- jpabraha@montefioredirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
111 E 210TH St
Bronx, NY 10467-2401
Other providers in Bronx, NY
- Cyril Paul Abraham
- Dunstan Abraham
- Francy Abraham
- Gallane Dabela Abraham
- Janell D. Abraham
- Leni Abraham
- Nitya Abraham
- Rita George Abraham
- Samirah Abraham
- Shinu Abraham
All providers in Bronx, NY · Student in an Organized Health Care Education/Training Program in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.