Individual provider Active NPI

Jason J Graf, PA-C

  • Physician Assistant
  • Elgin, IL
National Provider Identifier
1942372537
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.002376 Issued in IL
Practice address
1530 N Randall Rd Ste 210
Elgin, IL 60123-7879
Phone
(224) 760-7322
Fax
(224) 535-8252
NPI assigned
Nov 15, 2006
Last updated
Nov 7, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.002376 IL Primary

Addresses

Primary practice location

1530 N Randall Rd Ste 210
Elgin, IL 60123-7879

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 858-4106

Other identifiers 1

IdentifierTypeStateIssuer
1063955OtherNCCPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041105001112 IL Practitioner - Physician Assistant 5193788560 Reassigns benefits to 1 organization
I20210423000488 WI Practitioner - Physician Assistant 5193788560

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
24.47 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
81.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.002376ILMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541548800000",
    "number": "1942372537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-858-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N RANDALL RD STE 210",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237879",
            "telephone_number": "224-760-7322",
            "fax_number": "224-535-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAF",
        "first_name": "JASON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.002376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1063955",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.