MR. DONALD ROBERT ABRAHM M.D.
NPI 1215022405
Internal Medicine - Gastroenterology in Newport Beach, CA

Q: What is Donald Abrahm's NPI number?

The NPI number for Donald Abrahm is 1215022405. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Q: What is Donald Abrahm's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Donald Abrahm 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.

Active since October 04, 2006PECOS EnrolledAccepts Medicare Assignment

65.38/100

CMS Quality Rating

1525 SUPERIOR AVENUE, SUITE 104, NEWPORT BEACH, CA 92663(949) 631-2670(949) 631-7137 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Donald Robert Abrahm M.d. NPPES

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

MR. DONALD ROBERT ABRAHM M.D. (NPI 1215022405) is an individual gastroenterology provider in Newport Beach, California, licensed in California (G51196) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, San Francisco School Of Medicine (1980).

NPPES Registry Identity

NPI1215022405

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameMR. DONALD ROBERT ABRAHMCredential: M.D.

Location Address1525 SUPERIOR AVENUE, SUITE 104Newport Beach, CA 92663-3639

Mailing Address1525 Superior Avenue, Suite 104Newport Beach, CA 92663-3639 · (949) 631-2670 · Fax (949) 631-7137

Phone(949) 631-2670

Fax(949) 631-7137

Sole ProprietorNo

Medical School CMSUniversity Of California, San Francisco School Of MedicineGraduated 1980

Enumeration DateOctober 4, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1215022405 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in CA · G51196

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

1525 SUPERIOR AVENUE, Newport Beach, CA 92663

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Other Identifiers 2

OtherG51196CA · License Number

Medicare UPINA51929CA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Donald Robert Abrahm M.d. 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 ID6204904493

PECOS Enrollment IDI20081001000013

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 05D2117341

Donald R Abrahm MD Inc · Newport Beach, CA

Expired · Jul 31, 2026

CLIA Number05D2117341

Laboratory TypePhysician Office

Certificate Effective DateApril 13, 2023

Certificate Expiration DateJuly 31, 2026

Laboratory DirectorRooba Wardeh MD

Laboratory Phone(949) 646-6999

Laboratory LocationDonald R Abrahm MD Inc1525 Superior Ave, Ste 104, Newport Beach, CA 92663

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Areas of Expertise CMS Part B claims 14

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.

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.

1,117 services818 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

501 services488 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

416 services416 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

339 services338 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.

325 services325 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

199 services199 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.

182 services174 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

179 services179 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

113 services113 patients

Dilation of esophagus 43450

Dilation of the esophagus is a procedure aimed to stretch or open up your esophagus (the tube connecting your mouth to your stomach) when it's narrow. It helps to improve swallowing and alleviate discomfort. It's typically performed using a flexible tube or balloon, under sedation.

93 services91 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

93 services92 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

29 services29 patients

Imaging of digestive tract done from the inside of the digestive tract 91110

This procedure, known as an endoscopy, involves a small camera being passed into the digestive tract. It helps doctors to see the inside of your digestive system in detail. This can aid in diagnosing conditions or planning treatments. It's generally safe and can provide valuable information.

16 services16 patients

Removal of large bowel tissue using a flexible endoscope 45390

This procedure, known as a colonoscopy, involves using a flexible endoscope to examine and potentially remove tissue from the large intestine. The endoscope allows the doctor to view the bowel lining directly and remove any abnormal tissue for further analysis.

12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92663 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

$142.39 typical visit price

range $62.96 – $187.60

Typical copayment $35.59 (range $15.74 – $46.90)

Most-billed visit code 99204

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

65.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

61.52

Promoting Interoperability

Improvement Activities

Cost

80.58

Reported Quality Measures

Advance Care Plan

28%2,212 patients2/55-star benchmark: 100%

Colorectal Cancer Screening

87%2,567 patients4/55-star benchmark: 100%

Controlling High Blood Pressure

41%423 patients2/55-star benchmark: 98%

Documentation of Current Medications in the Medical Record

97%4,726 patients4/55-star benchmark: 100%

Ischemic Vascular Disease (IVD) All or None Outcome Measure (Optimal Control)

23%39 patients

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 58% · 1,098 patients

Patients screened: 62% · 1,098 patients

7%60 patients1/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

49%1,045 patients1/55-star benchmark: 100%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

74%242 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape B4034

Other-Enteral and Parenteral · category OB006N

4 suppliers23 claims518 services$2.52 avg. paid by Medicare

Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit B4152

Other-Enteral and Parenteral · category OB006N

4 suppliers17 claims8,707 services$0.25 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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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 Donald Abrahm's NPI number?

The NPI number for Donald Abrahm is 1215022405. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Where is Donald Abrahm located?

Donald Abrahm practices at 1525 Superior Avenue Suite 104, Newport Beach, CA 92663. The listed phone number is (949) 631-2670.

What is Donald Abrahm's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Donald Abrahm enrolled in Medicare?

Yes. Donald Abrahm is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Donald Abrahm 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.