Individual provider Active NPI

Andrew David Graves, M.D.

  • Diagnostic Radiology Physician
  • Tamuning, GU
National Provider Identifier
1760696702
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M-1715 Issued in GU
Practice address
548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone
(671) 646-5824
Fax
(671) 647-3527
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M-1715 GU Primary

Addresses

Primary practice location

548 S Marine Corps Dr
Tamuning, GU 96913-3539

Mailing address

548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130116000148 GU Practitioner - Diagnostic Radiology 4981857398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Takecare Insurance Company Inc 28 clinicians

Practice addresses (Care Compare)

548 S Marine Corps Dr
Tamuning, GU 96913-3539
Phone (671) 646-5825

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Takecare Insurance Company Inc. CurrentSince Dec 21, 2015 Accepting new patients

Locations

548 S Marine Corps Dr
Tamuning, GU 96913
Phone (671) 646-5824

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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1760696702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 S MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133539",
            "telephone_number": "671-646-5824",
            "fax_number": "671-647-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 S MARINE CORPS DR",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969133539",
            "telephone_number": "671-646-5824",
            "fax_number": "671-647-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ANDREW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GU",
            "license": "M-1715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.