Andre Gray, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

183790 Issued in NY

Practice address

264 W 118TH St
Renassiance Health Care Network
New York, NY 10026-1620

Phone

(212) 932-6500

Fax

(212) 932-6599

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arverne, NY
  • NPI 1497700736
  Medicare reassignment NPD
• Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ozone Park, NY
  • NPI 1134476443
  NPD
• Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jamaica, NY
  • NPI 1467708107
  NPD
• Joseph P. Addabbo Family Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brooklyn, NY
  • NPI 1578810883
  NPD

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1144318510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 W 118TH ST",
            "address_2": "RENASSIANCE HEALTH CARE NETWORK",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261620",
            "telephone_number": "212-932-6500",
            "fax_number": "212-932-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 W 118TH ST",
            "address_2": "RENASSIANCE HEALTH CARE NETWORK",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100261620",
            "telephone_number": "212-932-6500",
            "fax_number": "212-932-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "183790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01210402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katharina D. Graw-Panzer, M.D.
• Kesina M Gray-Graham
• Karla Maria Gray-Roncal, MD
• Aaron Gray
• Amanda Ellen Forbes Gray, WHNP
• Andrea H.E Gray, MD
• Arthur A. Gray, PH.D.
• Belinda Lee Gray, MSPT
• Betsy Gray, MSN, FNP-BC
• Brett Gray, ANP, MPH

• Pediatrics Physician in New York, NY
• Providers in New York, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.