Jay Allan Graves, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

020499 Issued in CT

Practice address

19 Halls Rd
Old Lyme, CT 06371-1457

Phone

(860) 434-8300

NPI assigned

Jan 2, 2007

Last updated

Nov 16, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351
  Medicare reassignment NPD
• Sound Medical Associates, PC

  • Family Medicine Physician
  • Ledyard, CT
  • NPI 1629021860
  NPD
• Conncare Inc

  • Internal Medicine Physician
  • Colchester, CT
  • NPI 1700962040

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1083771745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711457",
            "telephone_number": "860-434-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "063711457",
            "telephone_number": "860-434-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "JAY",
        "middle_name": "ALLAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "020499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001204999",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frontline Wellness LLC
• Shragit Glazman, MD
• Jeffrey Stuart Goldblatt, M.D.
• Karl M Goldkamp, ND
• Mark Gombotz
• Elizabeth Green
• Ruth E Greenblatt, PT
• Joel Greenwood
• Mary Elizabeth Groth, A.P.R.N., P.M.H.S.
• Sharon Hallahan

• Family Medicine Physician in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.