Evan Paul Graber, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4583 Issued in MA

Practice address

57 Cedar St
Worcester, MA 01609-2183

Phone

(508) 829-2275

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114084571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 WILLOW BROOK RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202719",
            "telephone_number": "508-829-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092183",
            "telephone_number": "508-829-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "EVAN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "W04423",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "004870",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5631229",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Khushi Goyal, MD
• Renu S Goyal, MD
• Sanjeev B Goyal, MD
• Madison Goyette
• Cynthia Jean Graber, PH.D.
• Grace Excel Health Care Services,LLC
• Grace Family Dental LLC
• Grace Home Care Incorporated
• Grace Medical PC
• Grace Riley Integrative Psychiatry, PLLC

• Psychologist in Worcester, MA
• Providers in Worcester, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.