Active NPI
Mark F. Graziano, MD
- Family Medicine Physician
- Kittery, ME
National Provider Identifier
1851480149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 011114
- Practice address
- 22 Shapleigh Rd
Kittery, ME 03904 - Phone
- (207) 439-4430
- Fax
- (207) 439-0968
- NPI assigned
- Oct 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 011114 | ME | Primary |
Addresses
Primary practice location
22 Shapleigh Rd
Kittery, ME 03904
Mailing address
22 Shapleigh Rd
Kittery, ME 03904-1455
Phone (207) 439-4430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 268360099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011114 | ME | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278633600000",
"number": "1851480149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 SHAPLEIGH RD",
"city": "KITTERY",
"state": "ME",
"postal_code": "039041455",
"telephone_number": "207-439-4430",
"fax_number": "207-439-0968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 SHAPLEIGH RD",
"city": "KITTERY",
"state": "ME",
"postal_code": "03904",
"telephone_number": "207-439-4430",
"fax_number": "207-439-0968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAZIANO",
"first_name": "MARK",
"middle_name": "F.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2010-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "011114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "268360099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kittery, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.