Individual provider Active NPI

Tyler David Gray, PA

  • Surgical Physician Assistant
  • Saratoga Springs, NY
National Provider Identifier
1083231369
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
025133 Issued in NY
Practice address
5 Care LN
Saratoga Springs, NY 12866-8623
Phone
(518) 489-2663
NPI assigned
Jul 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Surgical Physician Assistant 363AS0400X 025133 NY Primary

Addresses

Primary practice location

5 Care LN
Saratoga Springs, NY 12866-8623

Mailing address

121 Everett Rd Ste 100
Albany, NY 12205-1447
Phone (518) 453-9088

Other practice location 1

121 Everett Rd Ste 100
Albany, NY 12205-1447
Phone (518) 453-9088 ext. 3207

Other identifiers 1

IdentifierTypeStateIssuer
06141386MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200810001117 NY Practitioner - Physician Assistant 3375968233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopedicsny, LLPGroup PAC ID 6901898170, 115 clinicians

Practice addresses (Care Compare)

121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663

1768 Route 9
Halfmoon, NY 12065-2402
Phone (518) 489-2663

2388 Route 9
Mechanicville, NY 12118-3433
Phone (518) 489-2663

5 Care LN
Saratoga Springs, NY 12866-8623
Phone (518) 489-2663

500 State St
Schenectady, NY 12305-2414
Phone (518) 489-2663

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025133NYMDHome Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedicsny, LLP CurrentSince Aug 1, 2020 Accepting new patients
Orthopedicsny, LLP CurrentSince Aug 1, 2020 Accepting new patients

Locations

123 Everett Rd
Albany, NY 12205
Phone (518) 701-2000

123 Everett Rd
Ste 200
Albany, NY 12205

121 Everett Rd
Ste 100
Albany, NY 12205
Phone 5184539088 ext. 3239

3 Atrium Dr
Ste 150
Albany, NY 12205
Phone (518) 453-2361

16 Maxwell Dr
Clifton Park, NY 12065
Phone (518) 557-1800

121 Everett Rd
Colonie, NY 12205

250 Delaware Ave
Ste 200
Delmar, NY 12054
Phone (518) 655-1990

1768 Route 9
Halfmoon, NY 12065

2388 Route 9
Mechanicville, NY 12118
Phone (518) 587-0845

5 Care Ln
Saratoga Springs, NY 12866
Phone (518) 587-0845

5 Care Ln
Ste 101
Saratoga Springs, NY 12866

500 State St
Schenectady, NY 12305
Phone (518) 798-0767

Interoperability endpoints

  • Direct secure messaging: tgray788827@direct.trinity-health.org
  • Direct secure messaging: tgray@orthony.emadirect.md

Organizations & group practices 3

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

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1083231369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 EVERETT RD STE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051447",
            "telephone_number": "518-453-9088",
            "fax_number": "518-689-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CARE LN",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668623",
            "telephone_number": "518-489-2663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Everett Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122051447",
            "country_code": "US",
            "telephone_number": "518-453-9088 x3207",
            "fax_number": "518-689-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TYLER",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-02",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "025133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06141386",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.