Individual provider Active NPI

Jeremy H Graf, MD

  • Emergency Medicine Physician
  • Olney, MD
National Provider Identifier
1104817873
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D0058770 Issued in MD
Practice address
18101 Prince Philip Dr
Olney, MD 20832-1514
Phone
(301) 774-8900
Fax
(301) 570-8574
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0058770 MD Primary

Addresses

Primary practice location

18101 Prince Philip Dr
Olney, MD 20832-1514

Mailing address

1300 Piccard Dr
Ste 202
Rockville, MD 20850-4303
Phone (301) 921-7900

Other identifiers 1

IdentifierTypeStateIssuer
406008300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040414001585 MD Practitioner - Emergency Medicine 2668466251 Reassigns benefits to 1 organization
I20111028000031 DC Practitioner - Internal Medicine 2668466251 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0058770MDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Jun 15, 2013 Accepting new patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jul 2, 2002 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Jun 15, 2013 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jul 2, 2002 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine Current Accepting new patients
Mid-Atlantic Critical Care Services,L.L.C. Past Accepting new patients

Locations

20010 Century Blvd
Ste 200
Germantown, MD 20874

18101 Prince Philip Dr
Olney, MD 20832
Phone (301) 774-8618

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

Organizations & group practices 6

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1104817873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PICCARD DR",
            "address_2": "STE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504303",
            "telephone_number": "301-921-7900",
            "fax_number": "301-921-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 PRINCE PHILIP DR",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321514",
            "telephone_number": "301-774-8900",
            "fax_number": "301-570-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAF",
        "first_name": "JEREMY",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0058770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406008300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.