Active NPI
Gretchen Denise Graves, M.D.
- Pediatrics Physician
- Pittsburg, CA
National Provider Identifier
1306862040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G46185
- Practice address
- 2260 Gladstone Dr
Suite 2
Pittsburg, CA 94565-5125 - Phone
- (925) 427-0391
- Fax
- (925) 427-6797
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G46185 | CA | Primary |
Addresses
Primary practice location
2260 Gladstone Dr
Suite 2
Pittsburg, CA 94565-5125
Mailing address
2260 Gladstone Dr
Suite 2
Pittsburg, CA 94565-5125
Phone (925) 427-0391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G461850 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111110000863 | CA | Practitioner - Pediatric Medicine | 1254505191 | Practice locations: Pittsburg, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G46185 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Muir Health | Past | Accepting new patients | |
| Sutter Delta Medical Center | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Rehabilitation Hospital Unit
- Walnut Creek, CA
- NPI 1447269303
-
- General Acute Care Hospital
- Concord, CA
- NPI 1801821376
-
- General Acute Care Hospital
- Antioch, CA
- NPI 1124135132
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1306862040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2260 GLADSTONE DR",
"address_2": "SUITE 2",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945655125",
"telephone_number": "925-427-0391",
"fax_number": "925-427-6797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2260 GLADSTONE DR",
"address_2": "SUITE 2",
"city": "PITTSBURG",
"state": "CA",
"postal_code": "945655125",
"telephone_number": "925-427-0391",
"fax_number": "925-427-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "GRETCHEN",
"middle_name": "DENISE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G46185",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G461850",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Pittsburg, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.