Individual provider Active NPI

Jack Ebrahimpour Abrams, M.D.

  • Specialist
  • Las Vegas, NV
National Provider Identifier
1780684571
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9777 Issued in NV
Practice address
6450 Medical Center St
Suite 100
Las Vegas, NV 89148-2442
Phone
(702) 304-9494
Fax
(702) 304-9495
NPI assigned
Jul 22, 2005
Reactivated
Apr 6, 2006
Last updated
May 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9777 NV Primary
Ophthalmology Physician 207W00000X 9777 NV

Addresses

Primary practice location

6450 Medical Center St
Suite 100
Las Vegas, NV 89148-2442

Mailing address

4800 N 22ND St Ste 210
Phoenix, AZ 85016-4963
Phone (702) 304-9494

Other practice location 1

40 Capri Blvd
Lake Havasu City, AZ 86403-5661
Phone (928) 855-9477

Other identifiers 1

IdentifierTypeStateIssuer
002018382MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041119000207 NV Practitioner - Ophthalmology 0244294247 Reassigns benefits to 2 organizations
I20220617001091 AZ Practitioner - Ophthalmology 0244294247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of NevadaGroup PAC ID 6002894680, 8 clinicians

Practice addresses (Care Compare)

2110 E Flamingo Rd
Suite 210
Las Vegas, NV 89119-5193
Phone (702) 733-2020

40 Capri Blvd
Suite 102
Lake Havasu City, AZ 86403-5661
Phone (928) 855-9477

Merit-based Incentive Payment System (MIPS)

Final score
83.86 of 100Reported as group
Quality
81.82
Promoting interoperability
100
Improvement activities
40
Cost
64.4

Merit-based Incentive Payment System (MIPS)

Final score
90.84 of 100Reported as group
Quality
91.49
Promoting interoperability
100
Improvement activities
40
Cost
77.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9777NVMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Barnet Dulaney Perkins Eye Center, PC CurrentSince Apr 1, 2022 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Ophthalmology Current Accepting new patients
Eye Associates of Nevada Ophthalmology CurrentSince Oct 1, 2024 Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Ophthalmology CurrentSince Apr 1, 2022 Accepting new patients
Box Canyon Surgery Center LLC Past Accepting new patients
Barnet Dulaney Perkins Eye Center, PC Ophthalmology Past Accepting new patients
Retinal Consultants of Arizona LTD Ophthalmology Past Accepting new patients
Tapan R Shah, MD, LTD Ophthalmology PastSince Oct 1, 2002 Accepting new patients

Locations

40 Capri Blvd
Ste 102
Lk Havasu Cty, AZ 86403
Phone (520) 758-2020

1114 S Higley Rd
Mesa, AZ 85206
Phone (480) 264-2295

4800 N 22nd St
Ste 120
Phoenix, AZ 85016

4800 N 22nd St
Ste 200
Phoenix, AZ 85016

4800 N 22nd St
Ste 210
Phoenix, AZ 85016
Phone (602) 598-7488

825 S 20th Ave
Safford, AZ 85546
Phone (928) 428-6930

10424 S Eastern Ave
Ste 100
Henderson, NV 89052
Phone (702) 733-2020

2110 E Flamingo Rd
Ste 210
Las Vegas, NV 89119
Phone (702) 733-2020

2555 Box Canyon Dr
Las Vegas, NV 89128
Phone (702) 316-4400

Interoperability endpoints

  • Direct secure messaging: jack.abrams.p11@direct.avp.nextgenshare.com
  • Direct secure messaging: jack.abrams.p28@direct.avp.nextgenshare.com
  • Direct secure messaging: jack.abrams@direct.avp.nextgenshare.com

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1780684571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N 22ND ST STE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164963",
            "telephone_number": "702-304-9494",
            "fax_number": "702-304-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 MEDICAL CENTER ST",
            "address_2": "SUITE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482442",
            "telephone_number": "702-304-9494",
            "fax_number": "702-304-9495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Capri Blvd",
            "address_purpose": "LOCATION",
            "city": "Lake Havasu City",
            "state": "AZ",
            "postal_code": "864035661",
            "country_code": "US",
            "telephone_number": "928-855-9477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "JACK",
        "middle_name": "EBRAHIMPOUR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "9777",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NV",
            "license": "9777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002018382",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.