Individual provider Active NPI

Evan Graber, DO

  • Pediatric Endocrinology Physician
  • Wilmington, DE
National Provider Identifier
1124350582
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
C20010927 Issued in DE
Practice address
1600 Rockland Rd
Pediatric Endocrinology
Wilmington, DE 19803-3607
Phone
(302) 651-5965
Fax
(302) 651-4945
NPI assigned
Feb 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X C20010927 DE Primary

Addresses

Primary practice location

1600 Rockland Rd
Pediatric Endocrinology
Wilmington, DE 19803-3607

Mailing address

PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, DE2 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
I20141106000926 NJ Practitioner - EndocrinologyPractitioner - Pediatric Medicine 4587886569 Reassigns benefits to 1 organization
I20150727000225 DE Practitioner - Endocrinology 4587886569 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C20010927DEMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince May 30, 2015 Accepting new patients
The Nemours Foundation CurrentSince May 30, 2015 Accepting new patients
Cooper Pediatric Specialists, PC CurrentSince Aug 25, 2014 Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

Interoperability endpoints

  • Direct secure messaging: egraber49267@direct.nemours.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1124350582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-4200",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND RD",
            "address_2": "PEDIATRIC ENDOCRINOLOGY",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033607",
            "telephone_number": "302-651-5965",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-09",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "DE",
            "license": "C20010927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.