Jerry Puthenpurakal Abraham, MD, MPH, CMQ

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

141443 Issued in CA

Practice address

1400 S Grand Ave Ste 703
Usc-CHMC Family Medicine Residency Program
Los Angeles, CA 90015-3068

Phone

(213) 741-1106

Fax

(213) 741-1434

NPI assigned

Jun 30, 2014

Last updated

Mar 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jerry.abrahammd.p1@direct.jwch.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585267200000",
    "number": "1932514874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GRAND AVE STE 703",
            "address_2": "USC-CHMC FAMILY MEDICINE RESIDENCY PROGRAM",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153068",
            "telephone_number": "213-741-1106",
            "fax_number": "213-741-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GRAND AVE STE 703",
            "address_2": "USC-CHMC FAMILY MEDICINE RESIDENCY PROGRAM",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153068",
            "telephone_number": "213-741-1106",
            "fax_number": "213-741-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "JERRY",
        "middle_name": "PUTHENPURAKAL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH, CMQ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-30",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "141443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Abraham
• Daniel Abraham, MD
• Emily Sara Abraham, LCSW
• Esther Abraham, D.D.S.
• Jennifer Abraham
• Lianne-Therese Valerio Abraham, M.S., BCBA
• Marina Boulos Abraham
• Nicholas Michael Abraham, M.D.
• Paul Fawzi Abraham, MD
• Sharon Abraham

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.