Individual provider Active NPI

Thomas Hild Graham, M.D.

  • Neurology Physician
  • Paoli, PA
National Provider Identifier
1508860990
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD022547E Issued in PA
Practice address
11 Industrial Blvd Ste 204
Paoli, PA 19301
Phone
(610) 644-6251
Fax
(610) 644-1440
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD022547E PA Primary

Addresses

Primary practice location

11 Industrial Blvd Ste 204
Paoli, PA 19301

Mailing address

11 Industrial Blvd
Ste 204
Paoli, PA 19301-1620
Phone (610) 644-6251

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040225000356 PA Practitioner - Neurology 9638065857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Pennsylvania State University College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Valley Neurological Associates LLCGroup PAC ID 1355412636, 3 clinicians

Practice addresses (Care Compare)

11 Industrial Blvd
Paoli, PA 19301-1620
Phone (610) 644-6251

130 S Bryn Mawr Ave
Bryn Mawr Hsop
Bryn Mawr, PA 19010-3087
Phone (610) 526-3000

255 W Lancaster Ave
Paoli Hosp
Paoli, PA 19301-1620
Phone (610) 648-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Valley Neurological Associates LLC Neurology CurrentSince Jul 1, 2008 Accepting new patients
Lower Merion Neurology, PC Neurology PastSince Jan 14, 2019 Accepting new patients
Neurology Consultants Neurology Past Accepting new patients

Locations

11 Industrial Blvd
Ste 204
Paoli, PA 19301
Phone (610) 644-6251

Organizations & group practices 3

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 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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1508860990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD",
            "address_2": "STE 204",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011620",
            "telephone_number": "610-644-6251",
            "fax_number": "610-644-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 INDUSTRIAL BLVD STE 204",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "19301",
            "telephone_number": "610-644-6251",
            "fax_number": "610-644-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "THOMAS",
        "middle_name": "HILD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD022547E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.