Individual provider Active NPI

Robert Lynn Graham, M.D.

  • Internal Medicine Physician
  • Plano, TX
National Provider Identifier
1871536367
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E3559 Issued in TX
Practice address
4001 W 15TH St
Suite 245
Plano, TX 75093-5841
Phone
(972) 596-5222
Fax
(972) 596-5291
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E3559 TX Primary

Addresses

Primary practice location

4001 W 15TH St
Suite 245
Plano, TX 75093-5841

Mailing address

4001 W 15TH St
Suite 245
Plano, TX 75093-5841
Phone (972) 596-5222

Other identifiers 2

IdentifierTypeStateIssuer
098163102MedicaidTX
098163103OtherTXMEDICAID OTHER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20100506000493 TX Practitioner - Internal Medicine 9234221037 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3559TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas PLLC CurrentSince Nov 1, 1995 Accepting new patients
Medical Clinic of North Texas, PLLC Internal Medicine CurrentSince Nov 1, 1995 Accepting new patients
Medical Clinic of North Texas, PLLC Internal Medicine Current Accepting new patients

Locations

808 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 558-3937

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1871536367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST",
            "address_2": "SUITE 245",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935841",
            "telephone_number": "972-596-5222",
            "fax_number": "972-596-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W 15TH ST",
            "address_2": "SUITE 245",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935841",
            "telephone_number": "972-596-5222",
            "fax_number": "972-596-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ROBERT",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E3559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098163102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OTHER",
            "identifier": "098163103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.