Individual provider Active NPI

Kristina Graves

  • Family Nurse Practitioner
  • Albany, NY
National Provider Identifier
1861195091
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
351052 Issued in NY
Practice address
62 Hackett Blvd Ste 2
Albany, NY 12209-1756
Phone
(518) 465-3318
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 351052 NY Primary

Addresses

Primary practice location

62 Hackett Blvd Ste 2
Albany, NY 12209-1756

Mailing address

191 N Pearl St Apt 301
Albany, NY 12207-2431
Phone (518) 506-4706

Other practice location 1

258 Hoosick St Ste 204
Troy, NY 12180-2450
Phone (518) 272-4231

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230719001751 NY Practitioner - Nurse Practitioner 0345600599 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee and Burack OB GYN PCGroup PAC ID 9931164845, 5 clinicians

Practice addresses (Care Compare)

62 Hackett Blvd
Albany, NY 12209-1756
Phone (518) 465-3318

Hospital & facility affiliations

  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee and Burack OB/GYN, P.C. CurrentSince Jun 7, 2023 Accepting new patients

Locations

62 Hackett Blvd
Ste 2
Albany, NY 12209
Phone (518) 434-2244

62 Hackett Blvd
Albany, NY 12209
Phone (518) 434-2244

258 Hoosick St
Ste 204
Troy, NY 12180
Phone (518) 238-6028

Interoperability endpoints

  • Direct secure messaging: kgraves@jacobsleeburackmds.medentdirect.com

Organizations & group practices 1

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 2

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1861195091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 N PEARL ST APT 301",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122072431",
            "telephone_number": "518-506-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 HACKETT BLVD STE 2",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122091756",
            "telephone_number": "518-465-3318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "258 Hoosick St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "NY",
            "postal_code": "121802450",
            "country_code": "US",
            "telephone_number": "518-272-4231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "351052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.