Individual provider Active NPI

Roger Sloan Gray Jr., MD

  • Ophthalmology Physician
  • Rice Lake, WI
National Provider Identifier
1154323608
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
30897020 Issued in WI
Practice address
2820 S Wisconsin Ave
Rice Lake, WI 54868-8573
Phone
(745) 234-8444
Fax
(715) 234-0041
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 30897020 WI Primary

Addresses

Primary practice location

2820 S Wisconsin Ave
Rice Lake, WI 54868-8573

Mailing address

2715 Damon St
Eau Claire, WI 54701-3899
Phone (715) 834-8471

Other identifiers 1

IdentifierTypeStateIssuer
31602400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rgray@chippewavalley.emadirect.md Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20101119001212 WI Practitioner - Ophthalmology 8224920194

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
21.65 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30897020WIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chippewa Valley Eye Clinic LTD Ophthalmology CurrentSince Jan 24, 1990 Accepting new patients

Locations

2715 Damon St
Eau Claire, WI 54701
Phone (715) 834-8471

1110 Oak Ridge Dr
Eau Claire, WI 54701
Phone (715) 830-0732

2820 S Wisconsin Ave
Rice Lake, WI 54868
Phone (715) 234-8444

Interoperability endpoints

  • Direct secure messaging: rgray@chippewavalley.emadirect.md

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1154323608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 DAMON ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547013899",
            "telephone_number": "715-834-8471",
            "fax_number": "715-834-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 S WISCONSIN AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548688573",
            "telephone_number": "745-234-8444",
            "fax_number": "715-234-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ROGER",
        "middle_name": "SLOAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "30897020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31602400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rgray@chippewavalley.emadirect.md",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2820 S Wisconsin Ave",
            "city": "Rice Lake",
            "state": "WI",
            "country_code": "US",
            "postal_code": "548688573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.