Marvin Graham, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

8114 Issued in CT

Practice address

365 Montauk Ave
New London, CT 06320-4700

Phone

(860) 442-0711

NPI assigned

Mar 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT, NY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Connecticut Gi PLLCGroup PAC ID 9830110758, 243 clinicians

Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

86.54

Promoting interoperability

99.98

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

87.78 of 100Reported as group

Quality

77.53

Promoting interoperability

100

Improvement activities

40

Cost

76.35

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgraham420974@direct.ynhh.org

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.

• Connecticut Gi PLLC

  • Gastroenterology Physician
  • Hartford, CT
  • NPI 1023124625
  Medicare reassignment Care Compare group NPD
• Northeast Medical Group, Inc.

  • Internal Medicine Physician
  • Bridgeport, CT
  • NPI 1043278351

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Yale University

  • Anesthesiology Physician
  • New Haven, CT
  • NPI 1205822236
  Medicare reassignment Care Compare group NPD
• Integrated Anesthesia Associates LLC

  • Anesthesiology Physician
  • Shelton, CT
  • NPI 1881636397
  Medicare reassignment NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688

  Anesthesiology

  Medicare reassignment NPD
• Northeast Medical Group, Inc

  • Cardiovascular Disease Physician
  • Fairfield, CT
  • NPI 1366745267
  NPD
• Yale University

  • Adult Mental Health Clinic/Center
  • Hamden, CT
  • NPI 1134391824
  NPD
• Yale University

  • Durable Medical Equipment & Medical Supplies
  • Fairfield, CT
  • NPI 1548066962
  NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1073530879
  Care Compare affiliation
• Lawrence and Memorial Hospital, Inc.

  • General Acute Care Hospital
  • New London, CT
  • NPI 1700092459
  Care Compare affiliation

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1669930178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6305 MAPLE TREE LN",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331693",
            "telephone_number": "305-778-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "MARVIN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-05",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "8114",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "8114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669930178",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669930178",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Goodale, PA-C
• Dennis S Gordan, M.D.
• Erin Gorman, BA
• Barbara A Gotay Matthew, LADC
• GP Familycare, LLC
• Curt Wilson Gramlich, MD
• Kirstin Grant, PA
• Nancy M Grant, PNP
• Kathryn Marie Graves, APRN, NP-C
• Marla Kathleen Graves

• Certified Registered Nurse Anesthetist in New London, CT
• Providers in New London, CT by specialty
• Certified Registered Nurse Anesthetist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.