Individual provider Active NPI

Martin Crawford De Graw, MD

  • Family Medicine Physician
  • New Bern, NC
National Provider Identifier
1851345920
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
28166 Issued in NC
Practice address
1040 Medical Park Ave
New Bern, NC 28562-5248
Phone
(252) 633-1678
Fax
(252) 633-1403
NPI assigned
May 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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 28166 NC Primary

Addresses

Primary practice location

1040 Medical Park Ave
New Bern, NC 28562-5248

Mailing address

PO Box 12248
New Bern, NC 28561-2248
Phone (252) 633-1678

Other identifiers 2

IdentifierTypeStateIssuer
27986OtherNCBCBS OF NC
8927986MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080213000400 NC Practitioner - Family Practice 9436232550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Carolina Health Care PAGroup PAC ID 9739087693, 122 clinicians

Practice addresses (Care Compare)

1000 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 634-3278

1020 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 514-6685

1030 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 634-3278

1040 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 638-2273

900 Medical Park Ave
New Bern, NC 28562-5248
Phone (252) 639-5959

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28166NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Health Care PA Current Accepting new patients
Coastal Carolina Health Care PA Family Medicine CurrentSince Mar 3, 2008 Accepting new patients
Coastal Carolina Health Care PA Family Medicine CurrentSince Mar 3, 2008 Accepting new patients

Locations

1020 Medical Park Ave
New Bern, NC 28562
Phone (252) 514-6685

702 Newman Rd
New Bern, NC 28562
Phone (252) 633-5333

810 Kennedy Ave
New Bern, NC 28560
Phone (252) 514-6016

1040 Medical Park Ave
New Bern, NC 28562
Phone (252) 633-1678

Interoperability endpoints

  • Direct secure messaging: mdegraw27071@coastalcarolinahealthcenter.gardenplot.direct-ci.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": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1851345920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12248",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285612248",
            "telephone_number": "252-633-1678",
            "fax_number": "252-633-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MEDICAL PARK AVE",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625248",
            "telephone_number": "252-633-1678",
            "fax_number": "252-633-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE GRAW",
        "first_name": "MARTIN",
        "middle_name": "CRAWFORD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "28166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "27986",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8927986",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.