DR. ETHAN GRAHAM PH.D.
NPI 1477866812
Psychologist - Clinical in New York, NY

Q: What is Ethan Graham's NPI number?

The NPI number for Ethan Graham is 1477866812. It was assigned to this individual provider in the NPPES registry on July 14, 2010.

Q: What is Ethan Graham's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: Is Ethan Graham enrolled in Medicare?

No. Ethan Graham has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Ethan Graham was last updated on February 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 14, 2010Opted out of Medicare · through Apr 1, 2027

330 W 58TH ST STE 405, NEW YORK, NY 10019(718) 702-2437 Get Directions Write a Review

NPPES record last updated: February 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Ethan Graham Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ETHAN GRAHAM PH.D. (NPI 1477866812) is an individual clinical provider in New York, New York, licensed in New York (018415) and active in the NPI registry since July 2010. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1477866812

Entity TypeIndividualMale

Primary Taxonomy103TC0700X

Provider Legal NameDR. ETHAN GRAHAMCredential: PH.D.

Location Address330 W 58TH ST STE 405New York, NY 10019-1820

Mailing Address320 7th Ave # 330Brooklyn, NY 11215-4194 · (718) 702-2437

Phone(718) 702-2437

Sole ProprietorYes

Enumeration DateJuly 14, 2010

Last NPPES UpdateFebruary 2, 2021

NPPES CertifiedFebruary 2, 2021

✔ NPI 1477866812 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in NY · 018415

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

330 W 58TH ST STE 405, New York, NY 10019

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Ethan Graham Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2017 through April 1, 2027.

Opt-Out Effective DateApril 1, 2017

Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10019 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$198.19 typical visit price

range $65.69 – $198.19

Typical copayment $49.54 (range $16.42 – $49.54)

Most-billed visit code 99205

Established Patient

$114.88 typical visit price

range $21.20 – $160.66

Typical copayment $28.72 (range $5.30 – $40.16)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Graham's NPI number?

The NPI number for Ethan Graham is 1477866812. It was assigned to this individual provider in the NPPES registry on July 14, 2010.

Where is Ethan Graham located?

Ethan Graham practices at 330 W 58th St Ste 405, New York, NY 10019. The listed phone number is (718) 702-2437.

What is Ethan Graham's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Ethan Graham enrolled in Medicare?

No. Ethan Graham has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ethan Graham was last updated on February 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.