Active NPI
Patrick Thomas McGraw, M.D.
- Surgery Physician
- Fort Walton Beach, FL
National Provider Identifier
1174677124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 054016
- Practice address
- 1703 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1221 - Phone
- (850) 864-4033
- Fax
- (850) 864-4076
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | ME96681 | FL | |
| Surgery Physician | 208600000X | 054016 | GA | Primary |
| Surgery Physician | 208600000X | 21373 | MS |
Addresses
Primary practice location
1703 Lewis Turner Blvd
Fort Walton Beach, FL 32547-1221
Mailing address
11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223-1627
Phone (904) 396-1725
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071108000142 | FL | Practitioner - General Surgery | 0547357535 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Ohio State University College of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1711 E Hallandale Beach Blvd
Hallandale Beach, FL 33009-4621
Phone (954) 688-3968
19451 S Tamiami TRL
Fort Myers, FL 33908-4817
Phone (239) 747-2133
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054016 | GA | MD | Surgery Physician |
Organizations & group practices 2
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": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637107200000",
"number": "1174677124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11945 SAN JOSE BLVD",
"address_2": "STE 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322231627",
"telephone_number": "904-396-1725",
"fax_number": "904-396-4893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 LEWIS TURNER BLVD",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325471221",
"telephone_number": "850-864-4033",
"fax_number": "850-864-4076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGRAW",
"first_name": "PATRICK",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2021-11-17",
"certification_date": "2021-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME96681",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "054016",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MS",
"license": "21373",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.