Individual provider Active NPI

Robert F Graves, MD

  • Urology Physician
  • Sidney, NE
National Provider Identifier
1992886212
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
21510 Issued in NE
Practice address
1000 Pole Creek Xing
Sidney, NE 69162-2901
Phone
(308) 254-5825
Fax
(970) 347-8865
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 21510 NE Primary

Addresses

Primary practice location

1000 Pole Creek Xing
Sidney, NE 69162-2901

Mailing address

PO Box 202
Sidney, NE 69162-0202
Phone (308) 641-2101

Other identifiers 2

IdentifierTypeStateIssuer
10025486400MedicaidNE
115539300MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20090318000701 NE Practitioner - Urology 0749389989 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14303AZMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cheyenne County Hospital Association Inc CurrentSince Apr 1, 2011 Accepting new patients
Cheyenne County Hospital Association CurrentSince Apr 1, 2011 Accepting new patients
Regional West Physicians Clinic Urology Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Regional West Physicians Clinic Past Accepting new patients

Locations

645 Osage St
Sidney, NE 69162
Phone (308) 254-5825

1000 Pole Creek Xing
Sidney, NE 69162
Phone (308) 254-5825

Organizations & group practices 5

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1992886212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691620202",
            "telephone_number": "308-641-2101",
            "fax_number": "970-347-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 POLE CREEK XING",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691622901",
            "telephone_number": "308-254-5825",
            "fax_number": "970-347-8865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ROBERT",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "21510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025486400",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115539300",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, NE

Sources for this page

Verify at the official NPI Registry.