DR. STEPHEN ISRAEL ABEDON M.D.
NPI 1689628687
Radiology - Diagnostic Radiology in Daly City, CA

Q: What is Stephen Abedon's NPI number?

The NPI number for Stephen Abedon is 1689628687. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Q: Where is Stephen Abedon located?

Stephen Abedon practices at 1900 Sullivan Ave, Daly City, CA 94015. The listed phone number is (650) 691-6503.

Q: What is Stephen Abedon's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Q: Is Stephen Abedon enrolled in Medicare?

Yes. Stephen Abedon 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.

Q: Which organizations bill Medicare for Stephen Abedon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephen Abedon reassigns Medicare benefits to 16 organizations: West Bay Nephrology Associates (Daly City, CA), San Mateo Dialysis Associates (Burlingame, CA), Sutter Bay Medical Foundation (Orinda, CA), Advanced Radiology And Interventional Associates Inc (Stockton, CA), Kc Tan, M.D. Medical Corporation (Monterey Park, CA) and 11 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephen Abedon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Q: What insurance does Stephen Abedon accept?

Health plans from CareSource, Priority Health and Taro Health list Stephen Abedon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Q: Is Stephen Abedon affiliated with any hospitals?

According to CMS data, Stephen Abedon is affiliated with Lutheran Hospital Of Indiana, Greene County General Hospital, Maine Medical Center and Northern Light Eastern Maine Medical Center.

Q: When was this NPI record last updated?

The NPPES record for Stephen Abedon was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 May 22, 2006PECOS EnrolledAccepts Medicare Assignment

1900 SULLIVAN AVE, DALY CITY, CA 94015(650) 691-6503(650) 991-6755 Get Directions Write a Review

NPPES record last updated: March 25, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 25, 2026, Sep 23, 2020 (2 updates tracked since 2020).

On this page

About Dr. Stephen Israel Abedon M.d. NPPES

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

DR. STEPHEN ISRAEL ABEDON M.D. (NPI 1689628687) is an individual diagnostic radiology provider in Daly City, California, licensed in California (G70312) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1689628687

Entity TypeIndividualMale

Primary Taxonomy2085R0202X

Provider Legal NameDR. STEPHEN ISRAEL ABEDONCredential: M.D.

Location Address1900 SULLIVAN AVEDaly City, CA 94015-2200

Mailing AddressPo Box 6102Novato, CA 94948-6102 · (415) 884-3418 · Fax (415) 883-3406

Phone(650) 691-6503

Fax(650) 991-6755

Sole ProprietorNo

Medical School CMSOtherGraduated 1989

Enumeration DateMay 22, 2006

Last NPPES UpdateMarch 25, 20262 updates tracked since enumeration

NPPES CertifiedMarch 25, 2026

✔ NPI 1689628687 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Licenses✔ Licensed in CA · G70312✔ Licensed in IN · 01091119A

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Also ListedRadiology · Vascular & Interventional RadiologyTaxonomy 2085R0204X · License G70312 (CA)

1900 SULLIVAN AVE, Daly City, CA 94015

Open in Google Maps ↗

Secondary Practice Locations 3

Location 11100 Reid PkwyRichmond, IN 47374-1157 · Phone (765) 983-3264 · Fax (765) 983-3260

Location 2600 Marine BlvdMoss Beach, CA 94038-9641 · Phone (650) 563-7100 · Fax (650) 728-5701

Location 391 Westborough Blvd Ste 1010South San Francisco, CA 94080-3196 · Phone (650) 589-8880

Other Identifiers 2

Medicaid00G703120CA

Other110247226Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Priority Health, Taro Health.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. Stephen Israel Abedon 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 ID3173695889

PECOS Enrollment IDI20080711000212, I20240419000155

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 Reassignments

Medicare enrollment records show Stephen Abedon reassigns Medicare billing to 16 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

West Bay Nephrology Associates

0.3 mi

Nephrology

1498 SOUTHGATE AVE, SUITE 102
Daly City, CA 94015

Reassigned Medicare billing, California enrollment
16 clinicians in this Medicare group

NPI 1336117829 (650) 755-4492

San Mateo Dialysis Associates

7.8 mi

Nephrology

1750 EL CAMINO REAL, 15
Burlingame, CA 94010

Reassigned Medicare billing, California enrollment
14 clinicians in this Medicare group

NPI 1275604183 (650) 692-6302

Sutter Bay Medical Foundation

21 mi

Multi-Specialty

12 CAMINO ENCINAS
Orinda, CA 94563

Reassigned Medicare billing, California enrollment
4,479 clinicians in this Medicare group

NPI 1366898538 (510) 204-8180

Advanced Radiology And Interventional Associates Inc

68 mi

Diagnostic Radiology

1800 N CALIFORNIA ST
Stockton, CA 95204

Reassigned Medicare billing, California enrollment
110 clinicians in this Medicare group

NPI 1669123626 (209) 943-2000

Kc Tan, M.D. Medical Corporation

349 mi

Neuroradiology

525 N GARFIELD AVE
Monterey Park, CA 91754

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Kc Tan MD Medical Corporation
74 clinicians in this Medicare group

NPI 1215394036 (626) 522-6030

Pacific Imaging Associates LLC

542 mi

Diagnostic Radiology

1015 NW 22ND AVE
Portland, OR 97210

Reassigned Medicare billing, California enrollment
8 clinicians in this Medicare group

NPI 1265137574 (971) 340-2758

Ts Radiology Billings, LLC

543 mi

Diagnostic Radiology

2801 N GANTENBEIN AVE
Portland, OR 97227

Reassigned Medicare billing, California enrollment
8 clinicians in this Medicare group

NPI 1669413514 (503) 413-4032

Greene County General Hospital

1,910 mi

Hospitalist

1185 N 1000 W
Linton, IN 47441

Reassigned Medicare billing, California and Indiana enrollments
Also billed through NPI 1184695389 (Indiana)
8 clinicians in this Medicare group

NPI 1942703004 (812) 847-5212

Hendricks County Radiology Inc

1,936 mi

Diagnostic Radiology

1000 E MAIN ST
Danville, IN 46122

Reassigned Medicare billing, California enrollment
8 clinicians in this Medicare group

NPI 1588703946 (317) 745-3425

Henry County Memorial Hospital

1,975 mi

Orthopaedic Surgery

1 MEMORIAL SQ, SUITE 2100
Greenfield, IN 46140

Reassigned Medicare billing, Indiana enrollment
166 clinicians in this Medicare group

NPI 1497173306 (765) 521-7385

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 29

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.

X-ray of chest, 1 view 71045

A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.

202 services196 patients

Ct scan of abdomen and pelvis with contrast 74177

A CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.

172 services170 patients

Ct scan of chest without contrast 71250

A CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.

136 services135 patients

Ct scan head or brain without contrast 70450

A CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.

135 services135 patients

Ct scan of blood vessels of chest with contrast 71275

A CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.

106 services106 patients

Ct scan of abdomen and pelvis without contrast 74176

A CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.

101 services100 patients

Ct scan of chest with contrast 71260

A CT scan of the chest with contrast is an imaging procedure. A special dye (contrast) is used to highlight specific areas in your body, providing clearer pictures of your chest. This helps in diagnosing conditions related to your lungs, heart, and other chest structures.

83 services82 patients

Ct scan of upper spine without contrast 72125

A CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.

68 services68 patients

Ct scan of blood vessels of abdomen and pelvis with contrast 74174

A CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.

50 services50 patients

X-ray of abdomen, 1 view 74018

An X-ray of the abdomen, 1 view, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the structures in your abdomen, such as the stomach, liver, and intestines. This can help identify issues like blockages, infections, or injuries.

40 services36 patients

X-ray of chest, 2 views 71046

A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.

37 services37 patients

Limited ultrasound scan of abdomen 76705

A limited ultrasound scan of the abdomen is a non-invasive imaging test. It uses sound waves to produce images of the abdominal organs such as the liver, gallbladder, spleen, pancreas, and kidneys. This helps to identify any abnormalities or issues.

31 services31 patients

Ct scan of lower spine without contrast 72131

A CT scan of the lower spine without contrast is a non-invasive imaging test. It uses X-rays to create detailed images of your lower back area, helping to detect conditions like fractures, infections, or tumors. It's painless and generally quick.

29 services29 patients

Ultrasound study of one arm or leg veins with compression and maneuvers 93971

This is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.

26 services26 patients

Ct scan of leg without contrast 73700

A CT scan of the leg is a non-invasive imaging test that uses X-rays to capture detailed images of your leg's bones, muscles, and blood vessels. It doesn't use contrast dye and doesn't cause any pain. It helps in diagnosing injuries or diseases.

22 services21 patients

Ct scan of blood vessels of neck with contrast 70498

A CT scan of the neck's blood vessels with contrast is a diagnostic procedure. It uses X-rays and a special dye to create detailed images of your neck's blood vessels. This helps doctors detect issues such as blockages or abnormalities.

21 services21 patients

Ct scan of pelvis without contrast 72192

A CT scan of the pelvis without contrast is a non-invasive imaging test. It uses X-rays to create detailed pictures of your lower abdomen area. It helps in detecting issues like injuries, inflammation, or abnormal growths. It doesn't involve any dye injection.

20 services20 patients

Ct scan of blood vessels of head with contrast 70496

A CT scan of the head's blood vessels with contrast is a diagnostic procedure. A special dye (contrast) is injected into your body to make the blood vessels visible on the scan. This helps identify issues like blockages or abnormalities in your head's blood vessels.

19 services19 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

18 services17 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

18 services16 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

17 services17 patients

Ct scan of abdominal aorta and both leg arteries with contrast 75635

A CT scan of the abdominal aorta and both leg arteries with contrast is a medical imaging procedure. A special dye is injected to make your blood vessels visible on the scan. This helps to check for any blockages or abnormalities in these areas.

17 services17 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

16 services16 patients

Mri scan of abdomen before and after contrast 74183

An MRI scan of the abdomen before and after contrast provides detailed images of your abdominal organs. Initially, images are taken without a contrast agent. Then, a safe dye is administered, usually via an IV, to highlight certain areas, giving a clearer picture to help diagnose various conditions.

16 services16 patients

3d radiographic procedure 76376

A 3D radiographic procedure is a non-invasive imaging test that helps doctors visualize the internal structures of your body in three dimensions. This advanced technology provides detailed images, aiding in accurate diagnosis and treatment planning. It involves exposure to minimal radiation.

16 services16 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

15 services15 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

14 services12 patients

X-ray of thigh bone, minimum 2 views 73552

An X-ray of the thigh bone is a non-invasive imaging test. It involves passing a small amount of radiation through the thigh to produce images of the bone structure. At least two different angles are captured for a comprehensive view. This helps detect fractures, infections, or other abnormalities.

14 services12 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150017

Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County

Emergency services Birthing friendly

Greene County General Hospital

Critical Access Hospitals · Linton, IN

4/5 CMS rating

OwnershipGovernment - Local

CMS Certification Number151317

Location1185 N 1000 WLinton, IN 47441 · Greene County

Emergency services Birthing friendly

Maine Medical Center

Acute Care Hospitals · Portland, ME

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200009

Location22 Bramhall StPortland, ME 04102 · Cumberland County

Emergency services Birthing friendly

Northern Light Eastern Maine Medical Center

Acute Care Hospitals · Bangor, ME

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number200033

Location489 State StreetBangor, ME 04401 · Penobscot County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94015 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

$104.51 typical visit price

range $69.00 – $202.35

Typical copayment $26.12 (range $17.25 – $50.58)

Most-billed visit code 99203

Established Patient

$84.91 typical visit price

range $23.44 – $166.46

Typical copayment $21.22 (range $5.86 – $41.61)

Most-billed visit code 99213

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.

Reported Quality Measures

Appropriate Follow-up Imaging for Incidental Abdominal Lesions

Percentage of final reports for abdominal imaging studies for asymptomatic patients aged 18 years and older with one or more of the following noted incidentally with follow_up imaging recommended: - Liver lesion =< 0.5 cm - Cystic kidney lesion < 1.0 cm -…

Lower rates are better for this measure.

84%44 patients

Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques

Percentage of final reports for patients aged 18 years and older undergoing CT with documentation that one or more of the following dose reduction techniques were used: - Automated exposure control - Adjustment of the mA and/or kV according to patient size -…

74%732 patients

Radiology: Reminder System for Screening Mammograms

Percentage of patients undergoing a screening mammogram whose information is entered into a reminder system with a target due date for the next mammogram

100%140 patients

Radiology: Stenosis Measurement in Carotid Imaging Reports

Percentage of final reports for carotid imaging studies (neck magnetic resonance angiography [MRA], neck computed tomography angiography [CTA], neck duplex ultrasound, carotid angiogram) performed that include direct or indirect reference to measurements of…

100%30 patients

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.

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.

HUI MING YANG MD

Internal Medicine

1900 SULLIVAN AVE, LOWER LEVEL
DALY CITY, CA 94015

San Mateo County (415) 680-4135

AHMC SETON MEDICAL CENTER LLC

General Acute Care Hospital

1900 SULLIVAN AVE
DALY CITY, CA 94015

San Mateo County (650) 992-4000

DR. MARY FINNEGAN M.D.

Emergency Medicine

1900 SULLIVAN AVE
DALY CITY, CA 94015

San Mateo County (650) 992-4000

NORTHERN CALIFORNIA RADIATION THERAPISTS & ONCOLOGISTS MEDICAL GROUP

Radiology (Radiation Oncology)

1900 SULLIVAN AVE, RADIATION ONCOLOGY DEPT
DALY CITY, CA 94015

San Mateo County (209) 342-2300

DR. CARLO JERICHO S MAGTIBAY MD

Internal Medicine

1900 SULLIVAN AVE, LOWER LEVEL
DALY CITY, CA 94015

San Mateo County (415) 680-4135

SETON EMERGENCY PHYSICIANS INC

Emergency Medicine

1900 SULLIVAN AVE
DALY CITY, CA 94015

San Mateo County (650) 992-4000

ADELE MAKOW M.D

Emergency Medicine

1900 SULLIVAN AVE
DALY CITY, CA 94015

San Mateo County (415) 992-4000

TERESITA ARDONA ENRIQUEZ FNP

Nurse Practitioner (Family)

1900 SULLIVAN AVE
DALY CITY, CA 94015

San Mateo County (650) 992-4000

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 Stephen Abedon's NPI number?

The NPI number for Stephen Abedon is 1689628687. It was assigned to this individual provider in the NPPES registry on May 22, 2006.

Where is Stephen Abedon located?

Stephen Abedon practices at 1900 Sullivan Ave, Daly City, CA 94015. The listed phone number is (650) 691-6503.

What is Stephen Abedon's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Stephen Abedon enrolled in Medicare?

Yes. Stephen Abedon 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.

Which organizations bill Medicare for Stephen Abedon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stephen Abedon reassigns Medicare benefits to 16 organizations: West Bay Nephrology Associates (Daly City, CA), San Mateo Dialysis Associates (Burlingame, CA), Sutter Bay Medical Foundation (Orinda, CA), Advanced Radiology And Interventional Associates Inc (Stockton, CA), Kc Tan, M.D. Medical Corporation (Monterey Park, CA) and 11 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stephen Abedon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stephen Abedon accept?

Health plans from CareSource, Priority Health and Taro Health list Stephen Abedon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Stephen Abedon affiliated with any hospitals?

According to CMS data, Stephen Abedon is affiliated with Lutheran Hospital Of Indiana, Greene County General Hospital, Maine Medical Center and Northern Light Eastern Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Stephen Abedon was last updated on March 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.