Individual provider Active NPI

Alexander Stephen Graham

  • Physician Assistant
  • Prince Frederick, MD
National Provider Identifier
1720815764
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
985 Prince Frederick Blvd
Prince Frederick, MD 20678-3128
Phone
(410) 535-2005
NPI assigned
Sep 16, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

985 Prince Frederick Blvd
Prince Frederick, MD 20678-3128

Mailing address

985 Prince Frederick Blvd
Prince Frederick, MD 20678-3128
Phone (410) 535-2005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251109000200 MD Practitioner - Physician Assistant 3971093709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Calvert Internal Medicine Group, PAGroup PAC ID 1759371834, 40 clinicians

Practice addresses (Care Compare)

110 Hospital Rd
Suite 303
Prince Frederick, MD 20678-4044
Phone (410) 414-6559

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Calvert Internal Medicine Group PA CurrentSince Oct 15, 2025 Accepting new patients
Glenn G. Marinelli MD PA Past Accepting new patients
Calvert Digestive Disease Associates, Endoscopy and Surgery Center LLC PastSince Aug 17, 2025 Accepting new patients

Locations

110 Hospital Rd
Ste 303
Prnc Frederck, MD 20678
Phone (301) 475-8757

205 Steeple Chase Dr
Ste 304
Prnc Frederck, MD 20678
Phone (443) 486-4088

985 Prince Frederick Blvd
Ste 201
Prnc Frederck, MD 20678
Phone (410) 414-5329

Interoperability endpoints

  • Direct secure messaging: agraham@calvertinternalmedicine.medentdirect.com

Organizations & group practices 3

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1720815764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783128",
            "telephone_number": "410-535-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985 PRINCE FREDERICK BLVD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783128",
            "telephone_number": "410-535-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ALEXANDER",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.