Individual provider Active NPI

Benjamin Holloway Graham, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Dunedin, FL
National Provider Identifier
1326402371
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
143865 Issued in FL
Practice address
601 Main St
Dunedin, FL 34698-5848
Phone
(727) 734-6635
NPI assigned
Apr 6, 2016
Last updated
May 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 143865 FL Primary

Addresses

Primary practice location

601 Main St
Dunedin, FL 34698-5848

Mailing address

PO Box 3093
Boca Raton, FL 33431-0993
Phone (305) 822-6914

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
I20211006002523 FL Practitioner - Pathology 9133411085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 W 66TH St
Hialeah, FL 33016-1801
Phone (305) 823-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
143865FLMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Pathology Services, PA Anatomic Pathology & Clinical Pathology CurrentSince May 31, 2022 Accepting new patients
Palmetto Pathology Services PA Anatomic Pathology & Clinical Pathology CurrentSince May 31, 2022 Accepting new patients

Locations

3100 SW 37th Ave
Coral Gables, FL 33134
Phone (305) 441-6868

2001 W 68th St
Miami Lakes, FL 33016
Phone (305) 364-2151

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 2

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": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1326402371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3093",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334310993",
            "telephone_number": "305-822-6914",
            "fax_number": "305-822-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MAIN ST",
            "city": "DUNEDIN",
            "state": "FL",
            "postal_code": "346985848",
            "telephone_number": "727-734-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BENJAMIN",
        "middle_name": "HOLLOWAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "143865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunedin, FL

Sources for this page

Verify at the official NPI Registry.