Individual provider Active NPI

Patrick James Graham, DNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Portland, OR
National Provider Identifier
1437624038
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
201808936NP-PP Issued in OR
Practice address
9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643
Phone
(503) 216-1150
NPI assigned
Oct 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 201808936NP-PP OR Primary

Addresses

Primary practice location

9135 SW Barnes Rd Ste 461
Portland, OR 97225-6643

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

Other practice location 1

9205 SW Barnes Rd
Portland, OR 97225-6603
Phone (503) 216-1234

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pgraham981559@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190110001210 OR Practitioner - Nurse Practitioner 6901142090 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9135 SW Barnes Rd
Suite 461
Portland, OR 97225-6643
Phone (503) 216-1150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201808936NP-PPORMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 1, 2018 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 1, 2018 Accepting new patients

Locations

9135 SW Barnes Rd
Ste 461
Portland, OR 97225
Phone (503) 216-1150

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

Interoperability endpoints

  • Direct secure messaging: pgraham981559@oc.providencedirect.org

Organizations & group practices 8

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.

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": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1437624038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 SW BARNES RD STE 461",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256643",
            "telephone_number": "503-216-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9205 SW Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972256603",
            "country_code": "US",
            "telephone_number": "503-216-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "PATRICK",
        "middle_name": "JAMES",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OR",
            "license": "201808936NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pgraham981559@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9135 SW Barnes Rd Ste 461",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.