DR. SISAY MICHAEL ABRAHAM MD
NPI 1184088312
Family Medicine in Edwardsville, IL

Q: What is Sisay Michael Abraham's NPI number?

The NPI number for Sisay Michael Abraham is 1184088312. It was assigned to this individual provider in the NPPES registry on April 13, 2016.

Q: What is Sisay Michael Abraham's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 13, 2016PECOS EnrolledAccepts Medicare Assignment

2122 TROY RD STE 130, EDWARDSVILLE, IL 62025(618) 800-4500(618) 800-4501 Get Directions Write a Review

NPPES record last updated: March 4, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 4, 2025, Mar 8, 2023, Jan 29, 2021 and 2 more (5 updates tracked since 2017).

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About Dr. Sisay Michael Abraham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SISAY MICHAEL ABRAHAM MD (NPI 1184088312) is an individual family medicine provider in Edwardsville, Illinois, licensed in Illinois (036152633) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Alton Memorial Hospital, and is a graduate of Meharry Medical College School Of Medicine (2016).

NPPES Registry Identity

NPI1184088312

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SISAY MICHAEL ABRAHAMCredential: MD

Location Address2122 TROY RD STE 130Edwardsville, IL 62025-2540

Mailing AddressPo Box 959203 Ste 300Saint Louis, MO 63195-0001 · (618) 800-4500 · Fax (618) 800-4501

Phone(618) 800-4500

Fax(618) 800-4501

Sole ProprietorNo

Medical School CMSMeharry Medical College School Of MedicineGraduated 2016

Enumeration DateApril 13, 2016

Last NPPES UpdateMarch 4, 20255 updates tracked since enumeration

NPPES CertifiedMarch 4, 2025

✔ NPI 1184088312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in IL · 036152633

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2122 TROY RD STE 130, Edwardsville, IL 62025

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sisay Michael Abraham Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800182759

PECOS Enrollment IDI20200812002963

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sisay Michael Abraham reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fairview Heights Medical Group, Sc

30 mi

Internal Medicine

670 MASON RIDGE CENTER DR, STE 300
Saint Louis, MO 63141

Reassigned Medicare billing, Illinois enrollment
507 clinicians in this Medicare group

NPI 1811392210 (314) 996-7644

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 21

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

1,140 services18 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

426 services259 patients

Anticoagulant management of patient taking warfarin 93793

Anticoagulant management with warfarin involves monitoring and adjusting your medication to prevent blood clots while minimizing the risk of bleeding. Regular blood tests measure your response to warfarin, helping adjust your dose if necessary. It's crucial to maintain a consistent diet and promptly report any changes in your health.

314 services20 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

182 services182 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

122 services105 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

106 services83 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

89 services87 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

54 services25 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

52 services52 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

51 services51 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

36 services36 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

20 services20 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

20 services20 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

17 services14 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

16 services13 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

15 services14 patients

Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment G0402

An Initial Preventive Physical Examination, also known as a "Welcome to Medicare" visit, is a one-time, face-to-face visit during your first 12 months of Medicare enrollment. It includes a review of your health, as well as education and counseling about preventive services and further screenings.

15 services15 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

14 services13 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

14 services13 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

13 services13 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Alton Memorial Hospital

Acute Care Hospitals · Alton, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140002

LocationOne Memorial DriveAlton, IL 62002 · Madison County

Emergency services Birthing friendly

Jersey Community Hospital

Acute Care Hospitals · Jerseyville, IL

3/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number140059

Location400 Maple Summit RoadJerseyville, IL 62052 · Jersey County

Emergency services

Memorial Hospital

Acute Care Hospitals · Belleville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140185

Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County

Emergency services Birthing friendly

Anderson Hospital

Acute Care Hospitals · Maryville, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140289

Location6800 State Route 162Maryville, IL 62062 · Madison County

Emergency services Birthing friendly

Christian Hospital Northeast

Acute Care Hospitals · Saint Louis, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260180

Location11133 Dunn RoadSaint Louis, MO 63136 · St. Louis County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANITA R KELLER FNP

Nurse Practitioner (Family)