Siby Abraham
Individual provider Active NPI Adult Health Nurse Practitioner · Suwanee, GA
NPI 1902270846 · NPPES record last updated Nov 16, 2015
Key facts
- NPI
- 1902270846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- A0315009 (GA)
- Practice address
- 680 Grand Reserve Dr
Suwanee, GA 30024-1613 - Phone
- (201) 638-7001
- NPI assigned
- Nov 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northside Cardiovascular Professional Services, LLC
Practice addresses (Care Compare)
2200 Medical Ctr Blvd
Suite 200
Lawrenceville, GA 30046-7765
Phone (404) 962-6000
Hospital & facility affiliations
- Northside Hospital Forsyth
Merit-based Incentive Payment System (MIPS)
- Final score
- 77.82 of 100
- Quality
- 67.82
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 77.43
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160309001535 | GA | Practitioner - Nurse Practitioner | 7719283209 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0315009 | GA | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | A0315009 | GA | Yes |
Addresses
Primary practice location
680 Grand Reserve Dr
Suwanee, GA 30024-1613
Mailing address
680 Grand Reserve Dr
Suwanee, GA 30024-1613
Phone (201) 638-7001
Other providers in Suwanee, GA
- James R Abbott
- Rebecca F Abernathy
- Sabina Abjani
- Above Physical Therapy, LLC
- Samuel Abraham
- Brittany Nicole Abrams
- Candice Abrams
- Absolute Health Care Centers, Inc.
- Absolute Health Pain Relief Centers
- Absolute Spine and Health
All providers in Suwanee, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2015. 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.