Jack M Graham, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

F1600 Issued in TX

Practice address

1500 S Main St
Fort Worth, TX 76104-4917

Phone

(817) 702-1166

Fax

(817) 702-1405

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at Houston, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Maternal Fetal Medicine, PLLCGroup PAC ID 3779623186, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

96.38 of 100Reported as group

Quality

80.41

Promoting interoperability

100

Improvement activities

40

Cost

78.69

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Texas Maternal Fetal Medicine, PLLC

  • Maternal & Fetal Medicine Physician
  • Lewisville, TX
  • NPI 1487887071
  Medicare reassignment Care Compare group NPD
• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment NPD
• Fetal Care Consultants, LLC.

  • Maternal & Fetal Medicine Physician
  • Dallas, TX
  • NPI 1578883187
  Medicare reassignment NPD
• Congenital Heart Surgery Center PLLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Dallas, TX
  • NPI 1386700565
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1205801347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100186",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761850186",
            "telephone_number": "817-731-7771",
            "fax_number": "817-731-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-1166",
            "fax_number": "817-702-1405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 W College St",
            "address_purpose": "LOCATION",
            "city": "Grapevine",
            "state": "TX",
            "postal_code": "760512100",
            "country_code": "US",
            "telephone_number": "817-481-0111",
            "fax_number": "817-481-0112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JACK",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "F1600",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "TX",
            "license": "F1600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H3360",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139366218",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139366223",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4227216",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139366219",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10028874",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briana M Graham, LCDC
• Bryanna Elyce Graham, LCSW
• Dan R. Graham, LPC, NCC, BCPCC
• Dea L Graham, L.P.C.
• Deborah V Graham, LCPO
• Janice Graham
• Jason Graham
• Jessica Graham
• Kay Norma Graham, RD,LD
• Misty Gail Graham, WHNP

• Maternal & Fetal Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Maternal & Fetal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.

Verify at the official NPI Registry.