Individual provider Active NPI

Graham Barden Berry, MD

  • Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1851702013
Registry record updated Jan 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
274769 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5491
Phone
(617) 667-5048
Fax
(617) 667-5050
NPI assigned
May 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 274769 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5491

Mailing address

330 Brookline Ave
Boston, MA 02215-5491
Phone (617) 667-5048

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
I20190812000622 NC Practitioner - Anesthesiology 9234442039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of North Carolina at Chapel Hill School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

Hospital & facility affiliations

  • Firsthealth Moore Regional Hospital Hospital, Pinehurst, NC, CCN 340115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
274769MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
Pinehurst Anesthesia Associates, PA Anesthesiology CurrentSince Jul 9, 2019 Accepting new patients
Ambulatory Anesthesia of Pinehurst, PA Anesthesiology CurrentSince Jul 9, 2019 Accepting new patients

Locations

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

10 First Village Dr
Pinehurst, NC 28374
Phone (844) 278-5282

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.

Hospital & facility affiliations 4

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": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547424000000",
    "number": "1851702013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-5048",
            "fax_number": "617-667-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-667-5048",
            "fax_number": "617-667-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "GRAHAM",
        "middle_name": "BARDEN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-09",
        "last_updated": "2019-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "274769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.