Mark Lewis Graber, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

147814 Issued in NY

Practice address

Middleville Road
VA Medical Center - Medical Service - 111
Northport, NY 11768

Phone

(631) 261-4400

NPI assigned

Feb 17, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1568437218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "address_2": "VA MEDICAL CENTER",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MIDDLEVILLE ROAD",
            "address_2": "VA MEDICAL CENTER - MEDICAL SERVICE - 111",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "MARK",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "147814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Lauren Gore, NPFA
• Amie Rose Gorman, OTR/L
• Olivia G Gorman, M.S., CCC-SLP
• Holly White Gotta, LCSW
• Richard Gotta, PH.D.
• Douglas Gradel
• Heather Grant, M.D.
• Tiffany S Grant, LCSW
• Ashley L Greene, PHD
• Lorne Mary Groarke, M.D.

• Nephrology Physician in Northport, NY
• Providers in Northport, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.