PRATIBHA MARY ABRAHAM MD
NPI 1336589118
Internal Medicine - Endocrinology, Diabetes & Metabolism in Fenton, MO

Q: What is Pratibha Abraham's NPI number?

The NPI number for Pratibha Abraham is 1336589118. It was assigned to this individual provider in the NPPES registry on June 26, 2013.

Q: What is Pratibha Abraham's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Q: When was this NPI record last updated?

The NPPES record for Pratibha Abraham was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 June 26, 2013PECOS EnrolledAccepts Medicare Assignment

1011 BOWLES AVE STE 300, FENTON, MO 63026(636) 496-5048 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2020, Jan 9, 2019 (2 updates tracked since 2019).

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About Pratibha Mary Abraham Md NPPES

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

PRATIBHA MARY ABRAHAM MD (NPI 1336589118) is an individual endocrinology, diabetes & metabolism provider in Fenton, Missouri, licensed in Missouri (2018032435) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS, is affiliated with Mercy Hospital South, and maintains a secondary practice location in Fenton.

NPPES Registry Identity

NPI1336589118

Entity TypeIndividualFemale

Primary Taxonomy207RE0101X

Provider Legal NamePRATIBHA MARY ABRAHAMCredential: MD

Location Address1011 BOWLES AVE STE 300Fenton, MO 63026-2387

Mailing AddressPo Box 955534Saint Louis, MO 63195-5534

Phone(636) 496-5048

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateJune 26, 2013

Last NPPES UpdateNovember 3, 20202 updates tracked since enumeration

NPPES CertifiedNovember 3, 2020

✔ NPI 1336589118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians

Taxonomy Code207RE0101X

License✔ Licensed in MO · 2018032435

Definition

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

1011 BOWLES AVE STE 300, Fenton, MO 63026

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Secondary Practice Location 1

Location 1SSM Health Medical Group, 1011 Bowles Avenue, Suite 300Fenton, MO 63026 · Phone (636) 496-5048 · Fax (636) 496-5041

Accepted Insurance

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

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

Pratibha Mary 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 ID5294037933

PECOS Enrollment IDI20181229000090

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.

Areas of Expertise CMS Part B claims 4

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.

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

228 services65 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.

212 services159 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.

61 services61 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.

59 services54 patients

Hospital Affiliations CMS Care Compare 3

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

Mercy Hospital South

Acute Care Hospitals · Saint Louis, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260077

Location10010 Kennerly RoadSaint Louis, MO 63128 · St. Louis County

Emergency services

Ssm St Clare Health Center

Acute Care Hospitals · Fenton, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260081

Location1015 BowlesFenton, MO 63026 · Jefferson County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - St Louis

Acute Care Hospitals · Richmond Heights, MO

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260091

Location6420 Clayton RdRichmond Heights, MO 63117 · St. Louis County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63026 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

$128.28 typical visit price

range $55.65 – $169.38

Typical copayment $32.07 (range $13.91 – $42.34)

Most-billed visit code 99204

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

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.

Referred Medical Equipment & Supplies CMS DME claims 8

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

Supplies for maintenance of insulin infusion catheter, per week A4224

DME-Other DME · category DE017N

9 suppliers22 claims254 services$18.15 avg. paid by Medicare

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

9 suppliers25 claims835 services$2.36 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

38 suppliers118 claims374 services$6.06 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

20 suppliers43 claims68 services$1.11 avg. paid by Medicare

External ambulatory infusion pump, insulin E0784

DME-Other DME · category DE017N

4 suppliers34 claims34 services$301.10 avg. paid by Medicare

Insulin for administration through dme (i.e., insulin pump) per 50 units J1817

Treatment-Injections and Infusions (nononcologic) · category RI000N

8 suppliers20 claims2,600 services$7.27 avg. paid by Medicare

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

Other Providers at the Same Location NPPES 12

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

DR. JEFFREY P WILSON MD

Internal Medicine (Interventional Cardiology)