Lacy Jo Graham, APRN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95010753 Issued in CA

Practice address

1500 E. Duarte Road
Duarte, CA 91010

Phone

(626) 256-4673

NPI assigned

Sep 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OK, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

92.8 of 100Reported as group

Quality

78.51

Promoting interoperability

100

Improvement activities

40

Cost

70.37

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgraham48571@cityofhope.direct-ci.com
• Direct secure messaging: direct@cityofhope.direct-ci.com

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.

• City of Hope Medical Foundation

  • Hematology & Oncology Physician
  • Duarte, CA
  • NPI 1871886366
  Medicare reassignment NPD
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment NPD
• Jane Phillips Memorial Medical Center, Inc

  • Rehabilitation Hospital Unit
  • Bartlesville, OK
  • NPI 1053456111
  NPD (past)
• Northcoast Anesthesia Providers

  • General Acute Care Hospital
  • Westlake, OH
  • NPI 1174851554
  NPD (past)
• Owasso Medical Facility, Inc

  • General Acute Care Hospital
  • Owasso, OK
  • NPI 1144231432
  NPD (past)
• St John Medical Center Inc

  • Psychiatric Hospital Unit
  • Tulsa, OK
  • NPI 1144306382
  NPD (past)
• St. John Broken Arrow, Inc

  • General Acute Care Hospital
  • Broken Arrow, OK
  • NPI 1497988596
  NPD (past)

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1225439391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 512185",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900510185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. DUARTE ROAD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LACY",
        "middle_name": "JO",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-09",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "76537",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "113746",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@cityofhope.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "CITY OF HOPE MEDICAL FOUNDATION",
            "address_1": "1500 E. Duarte Road",
            "city": "Duarte",
            "state": "CA",
            "country_code": "US",
            "postal_code": "91010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John Michael Gonzalez
• Lorena Gonzalez, M.D.
• Miranda Gonzalez
• Omar Raul Gonzalez
• Svetlana Y Goutnik
• Frederic Grannis, MD
• Robert Grant
• Russell Gray, MD
• Stacy Wang Gray, M.D.
• Victoria Annaliese Green, MD

• Family Nurse Practitioner in Duarte, CA
• Providers in Duarte, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.