Individual provider Active NPI

Abraham I Awwad, DO

  • Nephrology Physician
  • St Petersburg, FL
National Provider Identifier
1962424531
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS7025 Issued in FL
Practice address
3622 Central Avenue
St Petersburg, FL 33711
Phone
(727) 322-0245
Fax
(727) 323-0994
NPI assigned
Jul 24, 2006
Last updated
Sep 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS7025 FL Primary

Addresses

Primary practice location

3622 Central Avenue
St Petersburg, FL 33711

Mailing address

3622 Central Avenue
St Petersburg, FL 33711
Phone (727) 322-0245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20061004000205 FL Practitioner - NephrologyPractitioner - Internal Medicine 4789680372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5633 1St Ave S
St Petersburg, FL 33707-1703

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS7025FLMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Abraham I Awwad DO, LLC Nephrology CurrentSince May 20, 2006 Accepting new patients
Central Dialysis LLC PastSince Nov 18, 2019 Accepting new patients
Premier Health and Care for You Past Accepting new patients

Locations

3622 Central Ave
St Petersburg, FL 33711
Phone (727) 322-0245

5631 1st Ave S
St Petersburg, FL 33707
Phone (727) 322-0245

5633 1st Ave S
St Petersburg, FL 33707
Phone (727) 322-0245

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aawwad188961@orlandohealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1962424531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33711",
            "telephone_number": "727-322-0245",
            "fax_number": "727-323-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 CENTRAL AVENUE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33711",
            "telephone_number": "727-322-0245",
            "fax_number": "727-323-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWWAD",
        "first_name": "ABRAHAM",
        "middle_name": "I",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "OS7025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.