Individual provider Active NPI

Jack Graham

  • Emergency Medicine Physician
  • Cleveland, OH
National Provider Identifier
1306406863
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.146959 Issued in OH
Practice address
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone
(216) 445-4500
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23856 NH
Emergency Medicine Physician 207P00000X 35.146959 OH Primary

Addresses

Primary practice location

9500 Euclid Ave
Cleveland, OH 44195-0001

Mailing address

9500 Euclid Ave
Department of Emergency Services
Cleveland, OH 44195-0001

Other practice location 1

8401 Market St
Boardman, OH 44512-6725
Phone (330) 729-2929

Other practice location 2

10 Alice Peck Day Dr
Lebanon, NH 03766-2900
Phone (603) 448-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240711000162 OH Practitioner - Emergency Medicine 7012339559 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 442-1270

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • MH St Joseph Warren Hospital Hospital, Warren, OH, CCN 360161
  • MH St Elizabeth Youngstown Hospital Hospital, Youngstown, OH, CCN 360064

Merit-based Incentive Payment System (MIPS)

Final score
98.99 of 100Reported as group
Quality
97.69
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.8 of 100Reported as group
Quality
79.54
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
89.13 of 100Reported as group
Quality
78.7
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.13 of 100Reported as group
Quality
79.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.146959OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
4M Emergency Systems Tod LLC Emergency Medicine CurrentSince Jun 13, 2024 Accepting new patients
4M Emergency Systems LLC Emergency Medicine CurrentSince Jun 13, 2024 Accepting new patients
Mahoning Valley Emergency Specialists LLC Emergency Medicine CurrentSince Jun 13, 2024 Accepting new patients
Mves Austintown LLC Emergency Medicine CurrentSince Jun 13, 2024 Accepting new patients
Mves Boardman LLC Emergency Medicine CurrentSince Jun 13, 2024 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Dec 4, 2025 Accepting new patients
Mercy Health Youngstown LLC Past Accepting new patients

Locations

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

1296 Tod Pl NW
Ste 200
Warren, OH 44485
Phone (330) 306-5040

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

6252 Mahoning Ave
Youngstown, OH 44515
Phone (330) 792-7418

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 and National Provider Directory roles.

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1306406863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "address_2": "DEPARTMENT OF EMERGENCY SERVICES",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-445-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 Market St",
            "address_purpose": "LOCATION",
            "city": "Boardman",
            "state": "OH",
            "postal_code": "445126725",
            "country_code": "US",
            "telephone_number": "330-729-2929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Alice Peck Day Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037662900",
            "country_code": "US",
            "telephone_number": "603-448-3121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "23856",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.146959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.