Individual provider Active NPI

Carolyn M Ray, M.D.

  • Hematology & Oncology Physician
  • Hartford, CT
National Provider Identifier
1174551840
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
043064 Issued in CT
Practice address
114 Woodland St
Cancer Center
Hartford, CT 06105-1208
Phone
(860) 714-5554
Fax
(860) 714-8047
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 043064 CT Primary

Addresses

Primary practice location

114 Woodland St
Cancer Center
Hartford, CT 06105-1208

Mailing address

1000 Asylum Ave
Suite 2109a
Hartford, CT 06105-1770
Phone (860) 714-6581

Other identifiers 1

IdentifierTypeStateIssuer
001430644MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cray9754@direct.stfranciscare.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20050628000230 CT Practitioner - Hematology/Oncology 8123063351 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043064CTMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Oct 5, 2009 Accepting new patients
Trinity Health of New England Provider Network Organization Inc Hematology & Oncology CurrentSince Oct 5, 2009 Accepting new patients
Oncology Associates, PC Past Accepting new patients

Locations

1300 Hall Blvd
Fl 3
Bloomfield, CT 06002
Phone (860) 714-2376

95 Woodland St
#1
Hartford, CT 06105

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

7 Magauran Dr
Stafford Springs, CT 06076
Phone (860) 684-8478

1000 Asylum Ave
Ste 2109A
West Hartford, CT 06105
Phone (860) 714-5058

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1174551840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "SUITE 2109A",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-6581",
            "fax_number": "860-714-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "address_2": "CANCER CENTER",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-5554",
            "fax_number": "860-714-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CT",
            "license": "043064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001430644",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cray9754@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "114 Woodland St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061051208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.