Individual provider Active NPI

Stephanie Graham, PAC

  • Medical Physician Assistant
  • Denver, CO
National Provider Identifier
1043706856
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0005464 Issued in CO
Practice address
777 Bannock St
Denver, CO 80204-4597
Phone
(303) 602-3899
Fax
(303) 602-3902
NPI assigned
Jul 4, 2018
Last updated
Jul 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X CO
Medical Physician Assistant 363AM0700X PA.0005464 CO Primary

Addresses

Primary practice location

777 Bannock St
Denver, CO 80204-4597

Mailing address

6774 Kline St
Arvada, CO 80004-1548
Phone (630) 440-3899

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011001439 CO Practitioner - Physician Assistant 9638421159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.65 of 100Reported as group
Quality
92.15
Promoting interoperability
100
Improvement activities
40
Cost
80.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.0005464COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority Single Specialty CurrentSince Dec 23, 2023 Accepting new patients
Denver Health and Hospital Authority CurrentSince Dec 23, 2023 Accepting new patients
Denver Health and Hospital Authority Past Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

Interoperability endpoints

  • Direct secure messaging: sgraham275785@direct.dhha.org

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1043706856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6774 KLINE ST",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800041548",
            "telephone_number": "630-440-3899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044597",
            "telephone_number": "303-602-3899",
            "fax_number": "303-602-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STEPHANIE",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-04",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0005464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.