Jerry L Gray, MD
Individual provider Active NPI Internal Medicine Physician · Windber, PA
NPI 1104818756 · NPPES record last updated Aug 12, 2008
Key facts
- NPI
- 1104818756
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD014719E (PA)
- Practice address
- 1599 Somerset Ave
Ste #1
Windber, PA 15963 - Phone
- (814) 467-5600
- Fax
- (814) 467-5605
- NPI assigned
- Aug 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- University of Pittsburgh School of Medicine, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gray Medical Associates
Practice addresses (Care Compare)
1599 Somerset Ave
Suite 1
Windber, PA 15963-1745
Phone (814) 467-5600
Hospital & facility affiliations
- Chan Soon- Shiong Medical Center at Windber
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061109000557 | PA | Practitioner - Internal Medicine | 7012994528 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gray Medical Associates | Current |
Accepting new patients | |
| Windber Hospital, Inc. | Past | Accepting new patients |
Locations
1599 Somerset Ave
#1
Windber, PA 15963
Phone (814) 467-5600
1599 Somerset Ave
Windber, PA 15963
Phone (814) 467-5600
Interoperability endpoints
- jlgray@491c40b0.micromddirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD014719E | PA | Yes |
Addresses
Primary practice location
1599 Somerset Ave
Ste #1
Windber, PA 15963
Mailing address
1599 Somerset Ave
Ste #1
Windber, PA 15963
Phone (814) 467-5600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008730650004 | Medicaid | PA |
Other providers in Windber, PA
- Brianne Joyce France-Layton
- Libang Fu
- Reid Gentile
- Jeffrey A Gracie
- Gray Medical Associates
- Patrick M. Gray
- Tom Hanik
- Cory Hartland
- Jamie Hicks
- Michelle Hicks
All providers in Windber, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.