Jonathan Abraham
Individual provider Active NPI Emergency Medicine Physician · MC Lean, VA
NPI 1831486232 · NPPES record last updated Jun 27, 2021
Key facts
- NPI
- 1831486232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0101257959 (VA)
- Practice address
- 8008 Westpark Dr
MC Lean, VA 22102-3109 - Phone
- (703) 287-6625
- NPI assigned
- Jul 6, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 22
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of the Mid Atlantic States, Inc
Practice addresses (Care Compare)
10701 Rosemary Dr
Manassas, VA 20109-7282
Phone (703) 257-3000
8008 Westpark Dr
MC Lean, VA 22102-3109
Phone (703) 287-6400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, VA
- 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 |
|---|---|---|---|---|
| I20150616002826 | DC | Practitioner - Emergency Medicine | 3072824119 | Reassigns benefits to 3 organizations |
| I20181220000899 | VA | Practitioner - Emergency Medicine | 3072824119 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101257959 | VA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alexandria Springfield Emergency Physicians PC | Emergency Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients | |
| Emergency Medicine Associates P.a., P.C. | Emergency Medicine | Current |
Accepting new patients |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Mid Atlantic States, Inc | Current |
Accepting new patients | |
| Alexandria Springfield Emergency Physicians PC | Emergency Medicine | Current |
Accepting new patients |
| Emergency Medicine Associates P.a., P.C. | Current |
Accepting new patients |
Locations
2101 E Jefferson St
Ste 6
Rockville, MD 20852
2101 E Jefferson St
Ste 4EAST
Rockville, MD 20852
2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853
1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500
4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000
1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000
10701 Rosemary Dr
Manassas, VA 20109
Phone (703) 257-3000
8008 Westpark Dr
Tysons Corner, VA 22102
Phone (703) 287-6400
14139 Potomac Mills Rd
Woodbridge, VA 22192
Phone (703) 257-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD043089 | DC | |
| Emergency Medicine Physician | 207P00000X | 0101257959 | VA | Yes |
Addresses
Primary practice location
8008 Westpark Dr
MC Lean, VA 22102-3109
Mailing address
8008 Westpark Dr
MC Lean, VA 22102-3109
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in MC Lean, VA
- Mohamed Abdalla
- Suhad Abdallah
- Abibi01 Corporation
- Abigail Counseling Services, LLC
- Annalise Oluwatoyin Abiodun
- Shallese Abrams
- Khawla Abuaqel
- Salma Elkadi Abugideiri
- Mona Ezzat Abuhamda
- Zviadi Aburjania
All providers in MC Lean, VA · Emergency Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2021. 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.