Individual provider Active NPI

Anthony Freeman Graves, FNP-C

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1053003012
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
SP027579 Issued in PA
Practice address
6212 Walnut St
Philadelphia, PA 19139-3706
Phone
(215) 476-6264
Fax
(215) 689-0893
NPI assigned
May 25, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X SP027579 PA Primary

Addresses

Primary practice location

6212 Walnut St
Philadelphia, PA 19139-3706

Mailing address

6136 170TH St Apt M4
Fresh Meadows, NY 11365-1957
Phone (718) 709-0940

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230814000538 PA Practitioner - Nurse Practitioner 8325400062 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Providers Partners PLLCGroup PAC ID 3375987480, 11 clinicians

Practice addresses (Care Compare)

25 N Lansdowne Ave
Lansdowne, PA 19050-2205
Phone (631) 268-5644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP027579PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Providers Partners PLLC CurrentSince Sep 1, 2025 Accepting new patients
Regional Healthcare Group LLC CurrentSince Jul 28, 2025 Accepting new patients
Consonant Healing Medical Associates CurrentSince Jun 20, 2025 Accepting new patients

Locations

909 Ridgebrook Rd
Ste 300
Sparks Glencoe, MD 21152
Phone (443) 483-9300

905 Tower Rd
#3188
Bristol, PA 19007
Phone (215) 785-3201

905 Tower Rd
Ste 3188
Bristol, PA 19007
Phone (443) 483-9300

25 N Lansdowne Ave
Lansdowne, PA 19050
Phone (631) 268-5644

6212 Walnut St
Philadelphia, PA 19139
Phone (215) 476-6264

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1053003012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 170TH ST APT M4",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651957",
            "telephone_number": "718-709-0940",
            "fax_number": "516-441-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6212 WALNUT ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393706",
            "telephone_number": "215-476-6264",
            "fax_number": "215-689-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ANTHONY",
        "middle_name": "FREEMAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-25",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP027579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.