Individual provider Active NPI

Kesina M Gray-Graham

  • Student in an Organized Health Care Education/Training Program
  • New York, NY
National Provider Identifier
1023537511
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1301 5TH Ave
New York, NY 10029-3119
Phone
(212) 426-3400
NPI assigned
Sep 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X NY Primary

Addresses

Primary practice location

1301 5TH Ave
New York, NY 10029-3119

Mailing address

101 W 137TH St Apt 4
New York, NY 10030-2536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103003047 MA Practitioner - Mental Health Counselor 5991295511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Sep 30, 2025 Accepting new patients

Locations

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1023537511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 137TH ST APT 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100302536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100293119",
            "telephone_number": "212-426-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY-GRAHAM",
        "first_name": "KESINA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.