Brent A. Graham, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD21539 Issued in OR

Practice address

9841 NW Ash St
Portland, OR 97229-6281

Phone

(503) 201-1120

NPI assigned

Feb 28, 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 4

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380
  Medicare reassignment NPD
• Oag Trauma Services LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1548669948
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1528035474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9841 NW ASH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9841 NW ASH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972296281",
            "telephone_number": "503-201-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BRENT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD21539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD464OR",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050069040",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136220",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8239592",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Grafton
• Antonia Larissa Gragg, PA-C
• Thomas G Gragnola, MD
• Alice Meyer Graham, M.S.
• Barbara Ann Graham, MD
• Brynn Graham, MACOM, L.AC.
• Cody Robert Graham, LCSW
• Coisha Gabrielle Graham
• Cory James Graham
• Elmer Jefferson Graham

• Anesthesiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.