NPIMap

Individual provider Active NPI

Gary F Graham, MD

  • Family Medicine Physician
  • Roosevelt, UT
National Provider Identifier
1811910359
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
343506-1205 Issued in UT
Practice address
210 W 300 N
Roosevelt, UT 84066-2336
Phone
(435) 722-6130
NPI assigned
Jul 25, 2006
Last updated
May 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 343506-1205 UT Primary

Addresses

Primary practice location

210 W 300 N
Roosevelt, UT 84066-2336

Mailing address

210 W 300 N
Roosevelt, UT 84066-2336
Phone (435) 722-6130

Other identifiers 1

IdentifierTypeStateIssuer
1811910359MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040205001007 UT Practitioner - Family Practice 7719870492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Virginia School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uintah Basin Medical CenterGroup PAC ID 0244131944, 62 clinicians

Practice addresses (Care Compare)

210 W 300
Roosevelt, UT 84066-2336

250 W 300
Roosevelt, UT 84066-2336
Phone (435) 722-4691

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.32 of 100Reported as apm
Quality
71.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Uintah Basin Medical Center CurrentSince Apr 1, 2014 Accepting new patients
Northeastern Utah Medical Group CurrentSince Jan 1, 2008 Accepting new patients
Uintah Basin Medical Center CurrentSince Apr 1, 2014 Accepting new patients
Northeastern Utah Medical Group Family Medicine CurrentSince Jan 1, 2008 Accepting new patients
Ubmc Anesthesiology PastSince Jul 1, 2020 Accepting new patients
Uintah Basin Medical Center Past Accepting new patients
Utah Valley Emergency Physicians Inc Family Medicine PastSince Dec 15, 2019 Accepting new patients

Locations

50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426

210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

210 W 300 N
Ste 753
Roosevelt, UT 84066

250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691

250 W 300 N
Ste 75
Roosevelt, UT 84066

250 W 300 N
Ste 752
Roosevelt, UT 84066
Phone (435) 722-4691

38080 W State Road 35
Tabiona, UT 84072
Phone (435) 848-5509

379 N 500 W
Vernal, UT 84078
Phone (435) 781-2030

405 N 500 W
Vernal, UT 84078
Phone (435) 781-2335

475 N 500 W
Vernal, UT 84078
Phone (435) 781-2030

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1811910359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-722-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-722-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GARY",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "343506-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811910359",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roosevelt, UT

Sources for this page

Verify at the official NPI Registry.