Individual provider Active NPI

William J Wray, P.A.

  • Physician Assistant
  • Mystic, CT
National Provider Identifier
1043278773
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00309 Issued in RI
Practice address
34 Water Street
Suite 2
Mystic, CT 06355
Phone
(860) 572-9994
Fax
(860) 572-9930
NPI assigned
May 2, 2006
Last updated
Nov 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00309 RI Primary

Addresses

Primary practice location

34 Water Street
Suite 2
Mystic, CT 06355

Mailing address

34 Water Street
Suite 2
Mystic, CT 06355
Phone (860) 572-9994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180425000903 CT Practitioner - Physician Assistant 0042299588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John R. West MD IncGroup PAC ID 5092719484, 4 clinicians

Practice addresses (Care Compare)

34 Water St
Suite 2
Mystic, CT 06355-2524
Phone (860) 572-9994

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.81 of 100Reported as individual
Quality
81.62
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Dermatology Inc Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1043278773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 WATER STREET",
            "address_2": "SUITE 2",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "06355",
            "telephone_number": "860-572-9994",
            "fax_number": "860-572-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.