Individual provider Active NPI

Sandra L Graham, P.T.

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1629250998
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
740 Issued in AK
Practice address
4315 Diplomacy Dr
Anmc - Physical Therapy Dept
Anchorage, AK 99508-5926
Phone
(907) 729-1248
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 740 AK Primary

Addresses

Primary practice location

4315 Diplomacy Dr
Anmc - Physical Therapy Dept
Anchorage, AK 99508-5926

Mailing address

4315 Diplomacy Dr
Anmc - Physical Therapy Dept
Anchorage, AK 99508-5926
Phone (907) 729-1248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080319000290 TX Practitioner - Physical Therapist in Private Practice 5092891895 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metlakatla Indian CommunityGroup PAC ID 5890691315, 19 clinicians

Practice addresses (Care Compare)

563 Brendible St
Metlakatla, AK 99926
Phone (907) 886-4741

P O Box
Suite 439
Metlakatla, AK 99926-0439

PO Box
Suite 439
Metlakatla, AK 99926

PO Box
Suite 439
Metlakatla, AK 99926-0439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
740AKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Maniilaq Association CurrentSince Jan 22, 2018 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Feb 4, 2013 Accepting new patients
Kodiak Area Native Association CurrentSince Jul 28, 2024 Accepting new patients
Metlakatla Indian Community CurrentSince May 1, 2017 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jun 18, 2017 Accepting new patients
Maniilaq Association CurrentSince Jan 22, 2018 Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Feb 4, 2013 Accepting new patients
Kodiak Area Native Association PastSince Jul 28, 2024 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1247 Mill Bay Rd
Unit Bc
Kodiak, AK 99615
Phone (907) 486-9800

1247 Mill Bay Rd
Ste B
Kodiak, AK 99615

3449 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-9800

3400 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-1377

Organizations & group practices 9

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": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1629250998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "address_2": "ANMC - PHYSICAL THERAPY DEPT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "address_2": "ANMC - PHYSICAL THERAPY DEPT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.