Individual provider Active NPI

Barbara L Gracious, M.D.

  • Child & Adolescent Psychiatry Physician
  • Columbus, OH
National Provider Identifier
1275579088
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
35.075792 Issued in OH
Practice address
495 E Main St
Columbus, OH 43215-5679
Phone
(614) 355-8007
Fax
(614) 355-8620
NPI assigned
Jun 21, 2006
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35.075792 OH
Child & Adolescent Psychiatry Physician 2084P0804X 35.075792 OH Primary

Addresses

Primary practice location

495 E Main St
Columbus, OH 43215-5679

Mailing address

Dept 781625
PO Box 78000
Detroit, MI 48278-1625
Phone (614) 355-8004

Other identifiers 2

IdentifierTypeStateIssuer
2846675MedicaidOH
0108229MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BARBARA.GRACIOUS@hca5.eclinicaldirectplus.com

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
I20171117002779 FL Practitioner - Psychiatry 3971675463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Northwestern University Feinberg Medical School, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Family Practice Associates, LLCGroup PAC ID 8820003411, 50 clinicians

Practice addresses (Care Compare)

1731 University Blvd S
Jacksonville, FL 32216-8928
Phone (904) 725-0200

2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone (904) 639-8500

2021 Professional Ctr Dr
Orange Park, FL 32073-4461

2029 Professional Ctr Dr
Orange Park, FL 32073-4461
Phone (904) 264-8621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.52 of 100Reported as group
Quality
78.57
Promoting interoperability
99
Improvement activities
40
Cost
74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.075792OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Family Practice Associates, LLC CurrentSince Sep 20, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1731 University Blvd S
Jacksonville, FL 32216
Phone (904) 725-0200

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1275579088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 781625",
            "address_2": "PO BOX 78000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781625",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155679",
            "telephone_number": "614-355-8007",
            "fax_number": "614-355-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACIOUS",
        "first_name": "BARBARA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.075792",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "35.075792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108229",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BARBARA.GRACIOUS@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "495 E Main St",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432155679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.