NPIMap

Individual provider Active NPI

Thomas Christopher Gray

  • Family Medicine Physician
  • Hillsboro, OR
National Provider Identifier
1174898373
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO16653 Issued in OR
Practice address
4660 NE Belknap CT
Suite 119
Hillsboro, OR 97124-6467
Phone
(503) 359-4773
NPI assigned
Mar 21, 2012
Last updated
Feb 14, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO16653 OR Primary

Addresses

Primary practice location

4660 NE Belknap CT
Suite 119
Hillsboro, OR 97124-6467

Mailing address

PO Box 189
Forest Grove, OR 97116-0189
Phone (503) 359-4773

Other identifiers 1

IdentifierTypeStateIssuer
500720355MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201000605 OR Practitioner - Family Practice 5890078687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Timothy J Gray DO LLCGroup PAC ID 1355390584, 11 clinicians

Practice addresses (Care Compare)

4660 NE Belknap CT
Suite 119
Hillsboro, OR 97124-8402
Phone (503) 359-4773

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO16653ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy J Gray DO LLC Family Medicine CurrentSince Dec 20, 2016 Accepting new patients

Locations

1909 Mountain View Ln
Ste 200
Forest Grove, OR 97116
Phone (503) 359-4773

4660 NE Belknap Ct
Ste 119
Hillsboro, OR 97124
Phone (503) 359-3809

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26386/brand/1/csg/1/fhir/r4
  • Direct secure messaging: thomas.gray.1@26386.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1174898373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971160189",
            "telephone_number": "503-359-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 NE BELKNAP CT",
            "address_2": "SUITE 119",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971246467",
            "telephone_number": "503-359-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "THOMAS",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO16653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500720355",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

Verify at the official NPI Registry.