Vaughan C Graves, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD028158E Issued in PA

Practice address

601 Walnut St
Suite L90
Phila, PA 19106-3304

Phone

(215) 238-1622

Fax

(215) 238-1944

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Dermatology

Education

Temple University School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Graves Derma Care Center, PC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1891852653
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1386687002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 WALNUT ST",
            "address_2": "SUITE L90",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191063304",
            "telephone_number": "215-238-1622",
            "fax_number": "215-238-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WALNUT ST",
            "address_2": "SUITE L90",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191063304",
            "telephone_number": "215-238-1622",
            "fax_number": "215-238-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "VAUGHAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD028158E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009410580004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela M Grabau, CRNP
• Roni Graham-Owens, M.ED
• Lakecia Graham, DH
• Grandfriendz, Inc.
• Desirea Grant, RN
• Tamara Raquel Gray, B.S.ED.
• Graysferry Medical Center
• Great American Optical
• Greater Philadelphia Health Action, Inc.
• Greater Philadelphia Health Action, Inc.

• Dermatology Physician in Phila, PA
• Providers in Phila, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.