Individual provider Active NPI

Jittu Abraham, NP

  • Nurse Practitioner
  • Newark, DE
National Provider Identifier
1902569353
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
LG-0011788 Issued in DE
Practice address
4923 Ogletown Stanton Rd Ste 200
Newark, DE 19713-2081
Phone
(302) 225-0451
Fax
(302) 225-0472
NPI assigned
Oct 21, 2021
Last updated
Oct 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LG-0011788 DE Primary

Addresses

Primary practice location

4923 Ogletown Stanton Rd Ste 200
Newark, DE 19713-2081

Mailing address

4923 Ogletown Stanton Rd Ste 200
Newark, DE 19713-2081
Phone (302) 225-0451

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jabraham@delawarekidney.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, PA, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211129001776 DE Practitioner - Nurse Practitioner 9335539758 Reassigns benefits to 1 organization
I20220128001483 PA Practitioner - Nurse Practitioner 9335539758 Reassigns benefits to 1 organization
I20220412001606 MD Practitioner - Nurse Practitioner 9335539758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology Associates PAGroup PAC ID 9830098177, 55 clinicians

Practice addresses (Care Compare)

701 N Clayton St
Suite 401
Wilmington, DE 19805-3165
Phone (302) 421-9411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0011788DEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates PA CurrentSince Dec 6, 2021 Accepting new patients

Locations

4923 Ogletown Stanton Rd
Ste 200
Newark, DE 19713
Phone (302) 225-0451

701 N Clayton St
Ste 401
Wilmington, DE 19805
Phone (302) 225-0451

137 W High St
Ste 1A
Elkton, MD 21921
Phone (410) 620-9200

291 Wilmington W Chester Pike
#P
Chadds Ford, PA 19317
Phone (484) 842-1798

Organizations & group practices 1

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": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1902569353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD STE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-225-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 OGLETOWN STANTON RD STE 200",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132081",
            "telephone_number": "302-225-0451",
            "fax_number": "302-225-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JITTU",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0011788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jabraham@delawarekidney.com",
            "affiliation": "N",
            "endpointDescription": "abraham direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "4923 Ogletown Stanton Rd Ste 200",
            "city": "Newark",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197132081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.