DANIEL ABRAHA (NPI# 1063419166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063419166 |
| Entity Type | Individual |
| Full Name | DANIEL ABRAHA |
| Credential | MD |
| Practice Address |
7950 W Jefferson Blvd Suite 210 Fort Wayne IN 46804-4140 |
| Mailing Address |
6920 Pointe Inverness Way Ste 200 Fort Wayne IN 46804-7934 |
| Practice Telephone | 2604357355 |
| Practice Fax Number | 2604357637 |
| Mailing Telephone | 2604793516 |
| Mailing Fax Number | 2604793520 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
01061925A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200816520 | 05 |
| Street Address |
7950 W JEFFERSON BLVD SUITE 210 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760486187 | Heather J. Wolfe | Pediatrics | 7950 W Jefferson Blvd, Suite 212, Fort Wayne, IN 46804-4140 | 2005-06-13 |
| 1831798354 | Dorian Raymone Tate | Nurse Anesthetist, Certified Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-26 |
| 1528665585 | Alexis Kate Felger | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-10-02 |
| 1114534054 | Mary Catherine Richter | Specialist/Technologist, Other | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-09-24 |
| 1538778386 | Lori Elizabeth Jackson | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-07-28 |
| 1831708965 | Anna N. Kemler | Nurse Practitioner | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-24 |
| 1699383307 | David James Mansfield | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-07-20 |
| 1932726452 | Joseph Egbert | Registered Nurse | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4140 | 2020-06-30 |
| 1245851872 | Lauren Tirey | Occupational Therapist | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2020-05-05 |
| 1609415421 | Mikhaila Sailor | Dietitian, Registered | 7950 W Jefferson Blvd, Fort Wayne, IN 46804-4160 | 2019-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225169196 | Pediatric Pulmonary & Critical Care, PC | Pediatrics | 7910 West Jefferson Blvd., Ste 205, Fort Wayne, IN 46804-4159 | 2007-03-09 |
| 1023198926 | Pediatric Specialty Physicians, PC | Pediatrics | 7429 Inverness Commons, Fort Wayne, IN 46804-3837 | 2006-10-16 |
| 1336161868 | Chandrashekhar Yalamanchali | Pediatrics | 11123 Parkview Plaza Dr Ste 202, Fort Wayne, IN 46845-1707 | 2006-07-24 |
| 1972892958 | Patrick J Noonan | Pediatrics | 7950 W Jefferson Blvd Ste 210, Fort Wayne, IN 46804-4140 | 2011-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619219995 | Casey Kathleen Mccluskey | Pediatrics | 705 Riley Hospital Dr Rm 5867, Pediatric Residency Program Indiana University Som, Indianapolis, IN 46202-5109 | 2013-03-25 |
| 1467408237 | Beacon Medical Group, Inc. | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601 | 2006-05-25 |
| 1962496661 | Susanna R Burkhead | Pediatrics | 3700 Washington Avenue, Evansville, IN 47750-0001 | 2005-09-08 |
| 1184012130 | Hari Rasad Gourabathini | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601-1033 | 2014-12-29 |
| 1396001194 | Michelle M Gombas | Pediatrics | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2012-04-05 |
| 1194954420 | Paul William Halczenko | Pediatrics | 2001 W 86th St, Indianapolis, IN 46260-1902 | 2009-07-08 |
| 1922213057 | Jiuann-huey Ivy Lin | Pediatrics | 705 Riley Hospital Dr, Rr 127, Indianapolis, IN 46202-5109 | 2007-05-11 |
| 1922193184 | Reuben Cohen | Pediatrics | 600 Mary St, Evansville, IN 47747-0001 | 2006-10-04 |
| 1053416784 | David F Westenkirchner | Pediatrics | 705 Riley Hospital Dr, Roc 4270, Indianapolis, IN 46202-5109 | 2006-09-14 |
| 1871602995 | Howard Eigen | Pediatrics | 705 Riley Hospital Dr, Ri 2117, Indianapolis, IN 46202-5109 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.