Individual provider Active NPI

Mary Bray, M.D.

  • Specialist
  • Mineola, NY
National Provider Identifier
1104802255
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
158100 Issued in NY
Practice address
200 Old Country Rd
Suite 350
Mineola, NY 11501-4235
Phone
(516) 739-2100
Fax
(516) 739-2178
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 158100 NY Primary

Addresses

Primary practice location

200 Old Country Rd
Suite 350
Mineola, NY 11501-4235

Mailing address

200 Old Country Rd
Suite 350
Mineola, NY 11501-4235
Phone (516) 739-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
158100NYMDSpecialist

Interoperability endpoints

  • Direct secure messaging: mbray9622@prd.direct.tbh.org

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104802255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 350",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "516-739-2100",
            "fax_number": "516-739-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 OLD COUNTRY RD",
            "address_2": "SUITE 350",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115014235",
            "telephone_number": "516-739-2100",
            "fax_number": "516-739-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "158100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.