Individual provider Active NPI

Nicholas Michael Abraham, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1770984098
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A132194 Issued in CA
Practice address
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Phone
(213) 977-2121
NPI assigned
Sep 5, 2014
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A132194 CA Primary

Addresses

Primary practice location

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (213) 977-2121

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicholas.abraham@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170515001093 CA Practitioner - Emergency Medicine 1759665482 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132194CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Apr 24, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 16, 2020 Accepting new patients
Providence Medical Foundation CurrentSince Apr 24, 2017 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jul 16, 2020 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1200 N State St
Los Angeles, CA 90089
Phone (323) 226-2170

1200 N State St
Ofc
Los Angeles, CA 90089
Phone (323) 226-6667

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

Interoperability endpoints

  • Direct secure messaging: nicholas.abraham@direct.usc.edu

Organizations & group practices 9

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1770984098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "213-977-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "NICHOLAS",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A132194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.abraham@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1225 Wilshire Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900171901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.