Individual provider Active NPI

Patrick Thomas McGraw, M.D.

  • Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1174677124
Registry record updated Nov 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
054016 Issued in GA
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

Updated by the provider on Nov 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
USA Vein Clinics of Miami LLCGroup PAC ID 9830404003, 11 clinicians

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

LicenseStateTypeSpecialty
054016GAMDSurgery 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

Verify at the official NPI Registry.