TRACY IVAN ABRAHAM PA
NPI 1124241872
Physician Assistant - Surgical in Bronx, NY
About Tracy Ivan Abraham Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRACY IVAN ABRAHAM PA (NPI 1124241872) is an individual surgical provider in Bronx, New York, licensed in New York (006753-1) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1998).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tracy Ivan Abraham Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BRONX, NY 10457
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Tracy Abraham's NPI number?
The NPI number for Tracy Abraham is 1124241872. It was assigned to this individual provider in the NPPES registry on April 11, 2007.
Where is Tracy Abraham located?
Tracy Abraham practices at 1650 Grand Concourse, Bronx, NY 10457. The listed phone number is (718) 901-8484.
What is Tracy Abraham's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Tracy Abraham enrolled in Medicare?
Yes. Tracy Abraham is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Tracy Abraham was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Tracy Ivan Abraham, PA · NPI 1124241872
Surgical physician in Bronx, New York. Individual provider, active in the CMS NPPES registry since April 11, 2007.
## Identity
- **NPI:** 1124241872 (Entity type: Individual)
- **Enumerated:** April 11, 2007
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 006753-1 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1650 GRAND CONCOURSE, Bronx, NY 10457
- **Phone:** (718) 901-8484
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 1998
## Record status
- **NPPES last updated:** July 8, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1124241872) · Data from the CMS NPPES public registry.