Individual provider Active NPI

Thomas Abey Abraham, M.D.

  • Pulmonary Disease Physician
  • Kalamazoo, MI
National Provider Identifier
1972607422
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
TA036531 Issued in MI
Practice address
5020 Lake Forest Dr
Kalamazoo, MI 49008-3382
Phone
(269) 381-1864
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X TA036531 MI Primary

Addresses

Primary practice location

5020 Lake Forest Dr
Kalamazoo, MI 49008-3382

Mailing address

5020 Lake Forest Dr
Kalamazoo, MI 49008-3382
Phone (269) 381-1864

Other identifiers 13

IdentifierTypeStateIssuer
4830001OtherMIPHP
1386418MedicaidMI
290C96034OtherMIBC/BS OF MICHIGAN
382356205106OtherMICOMMUNITY CHOICE OF MICH
118361OtherGRT LAKES HLTH PLAN
290006922OtherMIRAILROAD MEDICARE
290C913410OtherBCBS GRP PIN
4986915MedicaidMI
290390013OtherBCBS IND PIN
4379445OtherAETNA
P00606307OtherMIRAILROAD MEDICARE
4809115OtherPHP
P55003OtherMIBLUECARE NETWORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TA036531MIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Midwest, PC PastSince Jun 30, 2007 Accepting new patients
Bronson Methodist Hospital Pulmonary Disease Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1972607422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 LAKE FOREST DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083382",
            "telephone_number": "269-381-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 LAKE FOREST DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490083382",
            "telephone_number": "269-381-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAHAM",
        "first_name": "THOMAS",
        "middle_name": "ABEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "TA036531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "4830001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386418",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MICHIGAN",
            "identifier": "290C96034",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CHOICE OF MICH",
            "identifier": "382356205106",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRT LAKES HLTH PLAN",
            "identifier": "118361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290006922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP PIN",
            "identifier": "290C913410",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4986915",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IND PIN",
            "identifier": "290390013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4379445",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00606307",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "4809115",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE NETWORK",
            "identifier": "P55003",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.