Individual provider Active NPI

Robert W. Graham, PA-C

  • Surgical Physician Assistant
  • Wilmington, DE
National Provider Identifier
1356543565
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C50001153 Issued in DE
Practice address
701 N Clayton St
Wilmington, DE 19805-3165
Phone
(302) 354-5157
Fax
(302) 421-4367
NPI assigned
Jun 1, 2007
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA04942 TX
Surgical Physician Assistant 363AS0400X PA16989 CA
Surgical Physician Assistant 363AS0400X C50001153 DE Primary

Addresses

Primary practice location

701 N Clayton St
Wilmington, DE 19805-3165

Mailing address

701 N Clayton St
Wilmington, DE 19805-3165

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address robert.graham@direct.4.mycarefile.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181106000282 DE Practitioner - Physician Assistant 0143321497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Hospital IncGroup PAC ID 7911987144, 47 clinicians

Practice addresses (Care Compare)

701 N Clayton St
Wilmington, DE 19805-3165

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA16989CAMDSurgical Physician Assistant
C50001153DEMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Hospital Inc CurrentSince Nov 17, 2024 Accepting new patients
St Francis Hospital Inc CurrentSince Nov 17, 2024 Accepting new patients
St. Francis Hospital Inc. Past Accepting new patients
St Francis Hospital Inc Past Accepting new patients

Locations

701 N Clayton St
Wilmington, DE 19805
Phone (302) 421-4100

701 N Clayton St
Fl 2
Wilmington, DE 19805
Phone (302) 575-8040

701 N Clayton St
Fl 7
Wilmington, DE 19805

Interoperability endpoints

  • Direct secure messaging: rgraham2017870@direct.trinity-health.org
  • Direct secure messaging: robert.graham@direct.4.mycarefile.org

Organizations & group practices 5

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1356543565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N CLAYTON ST",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198053165",
            "telephone_number": "302-354-5157",
            "fax_number": "302-421-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ROBERT",
        "middle_name": "W.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA04942",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA16989",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DE",
            "license": "C50001153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "robert.graham@direct.4.mycarefile.org",
            "affiliation": "N",
            "endpointDescription": "St. Francis Hospital direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "701 N Clayton St",
            "city": "Wilmington",
            "state": "DE",
            "country_code": "US",
            "postal_code": "198053165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.