KENNETH DANIEL GRAHAM (PHYSICIAN ASSISTANT) – Physician Assistant, NPI 1164941977
Physician Assistant
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NPPES metrics only — not quality of care.
9,231 PHYSICIAN ASSISTANT in FL
Provider Addresses for KENNETH DANIEL GRAHAM (PHYSICIAN ASSISTANT)
7555 LOON AVE
WINTER GARDEN, FL 347875493
Phone: (678) 764-4234
Type: Mailing
11365 LEDGEMENT LN
WINDERMERE, FL 347866413
Phone: (678) 764-4234
Type: Mailing
2555 S KIRKMAN RD # RS
ORLANDO, FL 328112346
Phone: (407) 362-2030
Type: Location
4041 Ed Dr
Raleigh, NC 276128004
Phone: (919) 783-8377
Type: Location
2555 S Kirkman Rd # Rs
Orlando, FL 328112346
Phone: (407) 362-2030
Type: Location
100 Cornerstone Dr
Cary, NC 275198453
Phone: (919) 650-3660
Type: Location
1059 Beaver Creek Commons Dr Ste 230
Apex, NC 275023918
Phone: (919) 960-1300
Type: Location
Sentinel Ferry Lane, Weldon Ridge, Cary, Wake County, North Carolina, 27519-9443, United States
CARY, NC 275197554
Phone: (678) 764-4234
Type: Mailing
Hillandale Road, Omah Street, Durham, Durham County, North Carolina, 27705, United States
DURHAM, NC 277052671
Phone: (919) 383-4355
Type: Location
5716 FAYETTEVILLE RD
DURHAM, NC 277139661
Phone: (919) 572-1868
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-03-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171114002503 | I | Physician Assistant | NC | TBD |
| I20210324002264 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 46 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 20 | 20 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 19 | 18 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 15 | 15 | $0 |
Insurance plans in this area (ZIP 34787)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MD | |
| - | NC | |
| - | VA | |
| - | NC | |
| - | NC | |
| - | NC | |
| Physician Assistant | NC | |
| - | NC | |
| - | NC | |
| Family Practice, Internal Medicine | NC |
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