CMS-1500 Box 24J / 33a • NPI
1790267276
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
201 W 69TH ST, SIOUX FALLS, SD, 57108-2403
✓ 9-Digit EDI 837 ZIP+4 (57108-2403)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1790267276 (TRENT BOONE GRAVES, CNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1790267276)
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
36415 | Insertion of needle into vein for collection of blood sample | 184 |
38571 | Removal of lymph nodes of both sides of pelvis using an endoscope | 12 |
51741 | Electronic assessment of bladder emptying | 11 |
51798 | Ultrasound measurement of bladder capacity after voiding | 182 |
55866 | Surgical removal of prostate and surrounding lymph nodes using an endoscope | 14 |
74177 | Ct scan of abdomen and pelvis with contrast | 15 |
76770 | Complete ultrasound scan behind abdominal cavity | 49 |
81001 | Manual urinalysis test with examination using microscope, automated | 189 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Allopurinol Allopurinol | 12 | <11 |
| Cefdinir Cefdinir | 23 | 19 |
| Cephalexin Cephalexin | 51 | 49 |
| Ciprofloxacin Hcl Ciprofloxacin Hcl | 41 | 35 |
| Finasteride Finasteride | 131 | 42 |
| Methenamine Hippurate Methenamine Hippurate | 18 | <11 |
| Methocarbamol Methocarbamol | 13 | 13 |
| Myrbetriq Mirabegron | 50 | 14 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1790267276 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | TRENT BOONE GRAVES, CNP |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 201 W 69TH ST, SIOUX FALLS, SD, 57108-2403 |
| Practice Telephone / Fax | Tel: (605) 336-0635 |
| Administrative Mailing Address | 46213 252ND ST, HARTFORD, SD, 57033-5743 |
| Enumeration & Last Sync | Enumerated: 2018-08-31 | CMS Record Updated: 2018-08-31 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (TRENT BOONE GRAVES, CNP)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: SD | License: CP001433 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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