Active NPI
Kristen Graves, MD
- Internal Medicine Physician
- Syracuse, NY
National Provider Identifier
1316900582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 207577
- Practice address
- 819 S Salina St
Syracuse, NY 13202-3536 - Phone
- (315) 476-7921
- Fax
- (315) 475-1448
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 207577 | NY | Primary |
Addresses
Primary practice location
819 S Salina St
Syracuse, NY 13202-3536
Mailing address
819 S Salina St
Syracuse, NY 13202-3536
Phone (315) 476-7921
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02048951 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207577 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Syracuse Community Health Center, Inc. | Current | Accepting new patients | |
| Syracuse Community Health Center | Current | Accepting new patients | |
| Psychiatry Faculty Practice, Inc. | Current | Accepting new patients | |
| The Frederick Ferris Thompson Hospital | Past | Accepting new patients |
Locations
713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265
819 S Salina St
Syracuse, NY 13202
713 Harrison St
Syracuse, NY 13210
Phone (315) 464-3145
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Interoperability endpoints
- kgraves1@hiemail.healtheconnections.org
- krgraves@montefioredirect.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 4
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.
-
- Psychiatry Physician
- Syracuse, NY
- NPI 1881084820
-
- Federally Qualified Health Center (FQHC)
- Syracuse, NY
- NPI 1497796353
-
- Federally Qualified Health Center (FQHC)
- Syracuse, NY
- NPI 1184886988
-
- Community/Retail Pharmacy
- Victor, NY
- NPI 1831914274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459296000000",
"number": "1316900582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 S SALINA ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132023536",
"telephone_number": "315-476-7921",
"fax_number": "315-475-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "819 S SALINA ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132023536",
"telephone_number": "315-476-7921",
"fax_number": "315-475-1448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "KRISTEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-10",
"last_updated": "2016-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "207577",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02048951",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.