Active NPI
Jeffrey P Graham, CRNA
- Certified Registered Nurse Anesthetist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95001627
- Practice address
- 757 Westwood PLZ Ste 3325
Los Angeles, CA 90095-8358 - Phone
- (310) 267-3899
- NPI assigned
- Nov 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 95001627 | CA | Primary |
Addresses
Primary practice location
757 Westwood PLZ Ste 3325
Los Angeles, CA 90095-8358
Mailing address
5767 W Century Blvd Suite 400
Los Angeles, CA 90095-5631
Phone (310) 301-8707
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, MN
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3300 N Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-5370
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3044 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesiology, P.a. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients |
Locations
25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111
13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417
393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914
14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779
3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Robbinsdale, MN
- NPI 1013960798
Nurse Anesthetist, Certified Registered
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
-
- Health Maintenance Organization
- Lancaster, CA
- NPI 1982863783
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Robbinsdale, MN
- NPI 1851344907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1669138400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 W CENTURY BLVD SUITE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900955631",
"telephone_number": "310-301-8707",
"fax_number": "310-301-8751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ STE 3325",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958358",
"telephone_number": "310-267-3899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "JEFFREY",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-16",
"last_updated": "2023-09-21",
"certification_date": "2021-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95001627",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "13652 Cantara St",
"city": "Panorama City",
"state": "CA",
"country_code": "US",
"postal_code": "914025423",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.