Individual provider Active NPI

Thomas M Abraham Jr., DO

  • Obstetrics & Gynecology Physician
  • Erie, PA
National Provider Identifier
1770611899
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OS013194 Issued in PA
Practice address
100 Peach St
Suite 300
Erie, PA 16507-1423
Phone
(814) 459-1851
Fax
(814) 456-0541
NPI assigned
Mar 1, 2007
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OS013194 PA Primary

Addresses

Primary practice location

100 Peach St
Suite 300
Erie, PA 16507-1423

Mailing address

100 Peach St
Suite 300
Erie, PA 16507-1423
Phone (814) 459-1851

Other identifiers 1

IdentifierTypeStateIssuer
101892255MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070917000587 PA Practitioner - Obstetrics/Gynecology 7719071174 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS013194PAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Obstetrics & Gynecology CurrentSince May 1, 2017 Accepting new patients
University of Pittsburgh Physicians CurrentSince May 1, 2017 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

5035 Peach St
Erie, PA 16509
Phone (814) 480-7789

300 Halket St
Pittsburgh, PA 15213
Phone (412) 641-1000

Organizations & group practices 3

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1770611899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PEACH ST",
            "address_2": "SUITE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-459-1851",
            "fax_number": "814-456-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PEACH ST",
            "address_2": "SUITE 300",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071423",
            "telephone_number": "814-459-1851",
            "fax_number": "814-456-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "OS013194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101892255",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.