MARGARET ABRAHAM PHD
NPI 1053194407
Psychologist - Clinical in Wauwatosa, WI
NPI Status: Active since August 17, 2023
Contact Information
1155 N MAYFAIR RD
WAUWATOSA, WI
ZIP 53226
Phone: (414) 955-5990
Fax: (414) 955-6282
- Individual
- Female
- Psychologist
- Clinical
- Accepts Insurance
- PECOS Enrolled
About MARGARET ABRAHAM
This page provides the complete NPI Profile along with additional information for Margaret Abraham, a provider established in Wauwatosa, Wisconsin with a medical specialization in Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1053194407 assigned on August 2023. The practitioner's primary taxonomy code is 103TC0700X with license number 5166 (WI). The provider is registered as an individual and her NPI record was last updated 2 years ago.
- NPI
- 1053194407
- Provider Name
- MARGARET ABRAHAM PHD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1155 N MAYFAIR RD WAUWATOSA, WI 53226
- Location Phone
- (414) 955-5990
- Location Fax
- (414) 955-6282
- Mailing Address
- 1155 N MAYFAIR RD WAUWATOSA, WI 53226
- Mailing Phone
- (414) 955-5990
- Mailing Fax
- (414) 955-6282
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-17-2023
- Last Update Date
- 09-25-2024
- Code Navigator
A clinical psychologist like Margaret Abraham assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Clinical
- Taxonomy Code
- 103TC0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 5166
- License State
- WI
- Taxonomy Description
- A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | 5166 (WI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- HMO Bronze $0 Medical Deductible - HMO
- HMO Bronze 10000 - HMO
- HMO Bronze 7500 - HMO
- HMO Catastrophic 10600 with 3 free PCP visits - HMO
- HMO Gold 2000 - HMO
- HMO Gold 2700 - HMO
- HMO HDHP Silver 5900 - HMO
- HMO Silver 6000 - HMO
- HMO Silver 6600 - HMO
- POS Bronze 7500 - POS
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Essentia Choice Care with Medica Bronze HSA - EPO
- Prestige Bronze $0 Medical Deductible - HMO
- Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
- Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
- Prestige Bronze Essential + 3 Free PCP Visits - HMO
- Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
- Prestige Bronze Plus - HMO
- Prestige Gold - HMO
- Prestige Gold 50 + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
- Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1053194407 | MEDICAID (05) | WI |
Medicare Participation & PECOS Enrollment Status
Margaret Abraham is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 53226 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $163.24
- Minimum New Patient Price $53.9
- Maximum New Patient Price $163.24
- Average New Patient Copayment $40.81
- Minimum New Patient Copayment $13.47
- Maximum New Patient Copayment $40.81
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.41
- Minimum Established Patient Price $17.4
- Maximum Established Patient Price $133.76
- Average Established Patient Copayment $23.85
- Minimum Established Patient Copayment $4.35
- Maximum Established Patient Copayment $33.44
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053194407, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
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MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053194407, enumerated as an "individual" on August 17, 2023.
The provider is located at 1155 N MAYFAIR RD WAUWATOSA, WI 53226 and the phone number is (414) 955-5990.
Psychologist with taxonomy code 103TC0700X and a focus in Clinical.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.
