Mr Marvin Graham, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in New London, CT

Mr Marvin Graham, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in New London, Connecticut. He graduated from medical school in 2018 and has 6 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Northeast Medical Group Inc, Integrated Anesthesia Associates Llc and his current practice location is 365 Montauk Ave, New London, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 442-0711.

Mr Marvin Graham is licensed to practice in Connecticut (license number 8114) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1669930178.

Contact Information

Mr Marvin Graham, CRNA
365 Montauk Ave,
New London, CT 06320-4700
(860) 442-0711
Not Available



Physician's Profile

Full NameMr Marvin Graham
GenderMale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience6 Years
Location365 Montauk Ave, New London, Connecticut
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Marvin Graham graduated from medical school in 2018
  NPI Data:
  • NPI Number: 1669930178
  • Provider Enumeration Date: 03/05/2019
  • Last Update Date: 12/21/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0749520088
  • Enrollment ID: I20190322001100

Medical Identifiers

Medical identifiers for Mr Marvin Graham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669930178NPI-NPPES
1669930178MedicaidCT
1669930178MedicaidRI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207L00000XAnesthesiology 8114 (Connecticut)Secondary
367500000XNurse Anesthetist, Certified Registered 8114 (Connecticut)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Lawrence & Memorial HospitalNew london, CTHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northeast Medical Group Inc12542338361251
Integrated Anesthesia Associates Llc1759281165373

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Marvin Graham allows following entities to bill medicare on his behalf.
Entity NameIntegrated Anesthesia Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881636397
PECOS PAC ID: 1759281165
Enrollment ID: O20040112000163

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Entity NameNortheast Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043278351
PECOS PAC ID: 1254233836
Enrollment ID: O20040123000522

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Marvin Graham is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Marvin Graham, CRNA
6305 Maple Tree Ln,
East Lyme, CT 06333-1693

Ph: (305) 778-9477
Mr Marvin Graham, CRNA
365 Montauk Ave,
New London, CT 06320-4700

Ph: (860) 442-0711

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First Edition: August 24, 2011

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