Individual provider Active NPI

John E Hargraves, M.D.

  • Family Medicine Physician
  • Schenectady, NY
National Provider Identifier
1780919266
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
142517 Issued in NY
Practice address
3681 E Lydius St
Schenectady, NY 12303-3562
Phone
(518) 928-5708
Fax
(888) 225-7586
NPI assigned
Oct 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 142517 NY Primary
Internal Medicine Physician 207R00000X 142517 NY
General Practice Physician 208D00000X 142517 NY
Occupational Medicine Physician 2083X0100X 142517 NY

Addresses

Primary practice location

3681 E Lydius St
Schenectady, NY 12303-3562

Mailing address

3681 E Lydius St
Schenectady, NY 12303-3562
Phone (518) 928-5708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151123001939 NY Order and Referring Only - General PracticePractitioner - General PracticePractitioner - Internal MedicinePractitioner - Preventive MedicinePractitioner - Other (Physician) 3072813047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142517NYMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1780919266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3681 E LYDIUS ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123033562",
            "telephone_number": "518-928-5708",
            "fax_number": "888-225-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3681 E LYDIUS ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123033562",
            "telephone_number": "518-928-5708",
            "fax_number": "888-225-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGRAVES",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-16",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "142517",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "142517",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "142517",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "142517",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

Verify at the official NPI Registry.