Active NPI
Robert Graham, MD
- Internal Medicine Physician
- New York, NY
National Provider Identifier
1730154402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 250442
- Practice address
- 100 E 77TH St
New York, NY 10075-1850 - Phone
- (212) 434-2140
- Fax
- (212) 434-2446
- NPI assigned
- Feb 17, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 217405 | MA | |
| Internal Medicine Physician | 207R00000X | 250442 | NY | Primary |
Addresses
Primary practice location
100 E 77TH St
New York, NY 10075-1850
Mailing address
100 E 77TH St
New York, NY 10075-1850
Phone (212) 434-2140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2012618 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2016 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiologic Chiropractic & Physical Therapy, PLLC. | Past | Accepting new patients | |
| Physio Logic Medicine, P.C. | Past | Accepting new patients | |
| Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc | Internal Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/16096/brand/2/csg/1/fhir/r4
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.
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1013293588
-
- Chiropractor
- Brooklyn, NY
- NPI 1225262785
-
- Internal Medicine Physician
- Boston, MA
- NPI 1194765438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276819200000",
"number": "1730154402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E 77TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100751850",
"telephone_number": "212-434-2140",
"fax_number": "212-434-2446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 E 77TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100751850",
"telephone_number": "212-434-2140",
"fax_number": "212-434-2446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2010-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "217405",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "250442",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2012618",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.