Organization Active NPI

Richard H Graves DPM PC

  • Podiatrist
  • Long Beach, CA
National Provider Identifier
1245684844
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3954 Issued in CA
Legal business name
RICHARD H GRAVES DPM PC
Practice address
304 Cherry Ave
Long Beach, CA 90802-3848
Phone
(562) 433-0478
Fax
(562) 438-3690
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Dr. Richard Henry Graves III, DPMNPI 1912975434
Title
President
Phone
(562) 433-0478

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E3954 CA Primary

Addresses

Primary practice location

304 Cherry Ave
Long Beach, CA 90802-3848

Mailing address

304 Cherry Ave
Long Beach, CA 90802-3848
Phone (562) 433-0478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170324000986 CA Part B Supplier - Clinic/Group Practice 7315222825 Receives reassigned benefits from 4 practitioners
Practice locations: Long Beach, CA
O20171003005019 CA DME Supplier - Physician - Podiatry 7315222825 Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory
Tax ID family
Alamitos Beach Cities Podiatry Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5406 E Village Rd
Long Beach, CA 90808
Phone (562) 421-3747

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1245684844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CHERRY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023848",
            "telephone_number": "562-433-0478",
            "fax_number": "562-438-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 CHERRY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908023848",
            "telephone_number": "562-433-0478",
            "fax_number": "562-438-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD H GRAVES DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-433-0478",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.