NPIMap

Individual provider Active NPI

Daryl Wesley Graves, MD

  • Family Medicine Physician
  • Mount Vernon, NY
National Provider Identifier
1184698813
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
164011-1 Issued in NY
Practice address
12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone
(914) 664-8000
Fax
(914) 664-8015
NPI assigned
Feb 17, 2006
Last updated
Oct 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 164011-1 NY Primary

Addresses

Primary practice location

12 N 7TH Ave
Mount Vernon, NY 10550-2026

Mailing address

12 N 7TH Ave
Mount Vernon, NY 10550-2026
Phone (914) 664-8000

Other identifiers 1

IdentifierTypeStateIssuer
01544178MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001821 NY Practitioner - Family PracticePractitioner - Emergency Medicine 2769467067 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Georgetown University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Hill Emergency Physician ServicesGroup PAC ID 5395057020, 15 clinicians

Practice addresses (Care Compare)

127 S Broadway
Yonkers, NY 10701-4006
Phone (914) 378-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164011-1NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Mount Vernon Hospital CurrentSince Dec 17, 2014 Accepting new patients
Phelps Memorial Hospital Association CurrentSince Jan 1, 2005 Accepting new patients
Phelps Memorial Hospital Association CurrentSince Jan 1, 2005 Accepting new patients
Park Hill Emergency Physician Services CurrentSince Aug 13, 2017 Accepting new patients
Phelps Memorial Hospital Association Current Accepting new patients
Phelps Memorial Hospital Association Past Accepting new patients
The Mount Vernon Hospital Past Accepting new patients

Locations

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

12 N 7th Ave
Mount Vernon, NY 10550
Phone (914) 361-6511

701 N Broadway
Sleepy Hollow, NY 10591
Phone (914) 366-3140

127 S Broadway
Yonkers, NY 10701
Phone (914) 378-7342

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1184698813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-664-8000",
            "fax_number": "914-664-8015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 7TH AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502026",
            "telephone_number": "914-664-8000",
            "fax_number": "914-664-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "DARYL",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "164011-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01544178",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

Verify at the official NPI Registry.