Halcian L Graham, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9103552 Issued in FL

Practice address

2080 W Eau Gallie Blvd
Suite a
Melbourne, FL 32935-3185

Phone

(321) 254-6218

Fax

(321) 254-6230

NPI assigned

Nov 28, 2006

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: hgrahamlevy71482@epicdirect.hf.org

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.

• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  Medicare reassignment
• Brevard Emergency Services

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1104870393
  NPD (past)
• Space Coast Health Care Services

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1144274358
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1962578153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361907",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329361907",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 W EAU GALLIE BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353185",
            "telephone_number": "321-254-6218",
            "fax_number": "321-254-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "HALCIAN",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracefully Transparent L.L.C
• Agustin Gracia III, LCSW
• Kadri Graff
• Kenneth S Graff, MD
• Lynette M Graff, MD
• Iris Kathryn Graham, PA-C
• Matthew Graham
• Nascia Suean Graham, PMHNP
• Trinity Catherine Graham, ARNP
• Alexandra Grammenos, DO

• Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.