Active NPI
Roland James Graydon, MD
- Urology Physician
- Hartford, CT
National Provider Identifier
1659363075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 015005
- Practice address
- 85 Seymour St
Suite 416
Hartford, CT 06106-5501 - Phone
- (860) 947-8500
- Fax
- (860) 524-8643
- NPI assigned
- Aug 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 015005 | CT | Primary |
Addresses
Primary practice location
85 Seymour St
Suite 416
Hartford, CT 06106-5501
Mailing address
85 Seymour St
Suite 416
Hartford, CT 06106-5501
Phone (860) 947-8500
Other identifiers 21
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001150051 | Medicaid | CT | |
| 06-1406459 | Other | CT | PRIVATE HEALTHCARE SYSTEM |
| 3164870 | Medicaid | MA | |
| 06-1406459 | Other | CT | HMC, PPO |
| 06-1406459 | Other | CT | CORVEL |
| 06-1406459 | Other | CT | MULTIPLAN |
| 06-1406459 | Other | CT | COMMUNITY HEALTH NETWORK |
| 0S0306 | Other | CT | HEALTH NET |
| 06-1406459 | Other | CT | NORTHEAST HEALTH DIRECT |
| 076049 | Other | CT | CONNECTICARE |
| 06-1406459 | Other | CT | FOCUS |
| 06-1406459 | Other | CT | GREAT-WEST HEALTHCARE |
| 2054764 | Other | CT | AETNA |
| 06-1406459 | Other | CT | TRICARE |
| 12739 | Other | CT | HEALTH NEW ENGLAND |
| 342585 | Other | CT | WELLCARE |
| P1096767 | Other | CT | OXFORD |
| 010015005CT01 | Other | CT | ANTHEM BCBS |
| 06-1406459 | Other | CT | COLONIAL COOPERATIVE CARE |
| 06-1406459 | Other | CT | UNITED HEALTHCARE |
| 4915512 001 | Other | CT | CIGNA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015005 | CT | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Clinical Associates, P.C. | Urology | Past | Accepting new patients |
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": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301356800000",
"number": "1659363075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85 SEYMOUR ST",
"address_2": "SUITE 416",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061065501",
"telephone_number": "860-947-8500",
"fax_number": "860-524-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 SEYMOUR ST",
"address_2": "SUITE 416",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061065501",
"telephone_number": "860-947-8500",
"fax_number": "860-524-8643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYDON",
"first_name": "ROLAND",
"middle_name": "JAMES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-22",
"last_updated": "2011-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "CT",
"license": "015005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001150051",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIVATE HEALTHCARE SYSTEM",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3164870",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HMC, PPO",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMUNITY HEALTH NETWORK",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "0S0306",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTHEAST HEALTH DIRECT",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "076049",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FOCUS",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT-WEST HEALTHCARE",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2054764",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "12739",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "342585",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P1096767",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "010015005CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLONIAL COOPERATIVE CARE",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "06-1406459",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "4915512 001",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.