Individual provider Active NPI

Michael P. Graeff, RPH, FACA, CIP

  • Pharmacist
  • Gearhart, OR
National Provider Identifier
1609183698
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0005837 Issued in OR
Practice address
95 S Cottage Ave
Gearhart, OR 97138-4051
Phone
(971) 601-0551
NPI assigned
Sep 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH 00009612 WA
Pharmacist 183500000X RPH-0005837 OR Primary

Addresses

Primary practice location

95 S Cottage Ave
Gearhart, OR 97138-4051

Mailing address

95 S Cottage Ave
Gearhart, OR 97138-4051
Phone (971) 601-0551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH-0005837ORMDPharmacist
PH 00009612WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Noodles, Inc CurrentSince Jul 16, 2023 Accepting new patients

Locations

95 S Cottage Ave
Gearhart, OR 97138
Phone (971) 601-0551

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1284163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1609183698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 S COTTAGE AVE",
            "city": "GEARHART",
            "state": "OR",
            "postal_code": "971384051",
            "telephone_number": "971-601-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 S COTTAGE AVE",
            "city": "GEARHART",
            "state": "OR",
            "postal_code": "971384051",
            "telephone_number": "971-601-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEFF",
        "first_name": "MICHAEL",
        "middle_name": "P.",
        "credential": "RPH, FACA, CIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-11",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 00009612",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0005837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gearhart, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.