Individual provider Active NPI

Jason Fredrick Gray, MD

  • Anesthesiology Physician
  • Roseburg, OR
National Provider Identifier
1174565972
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD22276 Issued in OR
Practice address
2700 NW Stewart Pkwy
Roseburg, OR 97470-1281
Phone
(541) 673-0611
NPI assigned
Jun 13, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
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
Anesthesiology Physician 207L00000X MD22276 OR Primary

Addresses

Primary practice location

2700 NW Stewart Pkwy
Roseburg, OR 97470-1281

Mailing address

PO Box 4008
Portland, OR 97208-4008
Phone (503) 372-2740

Other identifiers 1

IdentifierTypeStateIssuer
170069MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20040407001194 OR Practitioner - Anesthesiology 7315930005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Oregon Health Sciences University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 673-0611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD22276ORMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Medical Group North, LLC CurrentSince Apr 6, 2011 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 1, 2023 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 1, 2023 Accepting new patients
Roseburg Anesthesiology Specialists Anesthesiology CurrentSince Jan 2, 2004 Accepting new patients
Centennial Medical Group North, LLC Current Accepting new patients
Centennial Medical Group Inc. PastSince Apr 5, 2011 Accepting new patients
Roseburg Clinic, P.C. Past Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

2801 NW Mercy Dr
Roseburg, OR 97471
Phone (541) 222-2700

2801 NW Mercy Dr
Ste 200
Roseburg, OR 97471
Phone (541) 673-0611

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Evergreen Family Medicine SouthMyrtle Creek, OR, CCN 383891 Rural health clinic Corporate Officer Apr 15, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1174565972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084008",
            "telephone_number": "503-372-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NW STEWART PKWY",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701281",
            "telephone_number": "541-673-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JASON",
        "middle_name": "FREDRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD22276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170069",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

Verify at the official NPI Registry.