Jennifer P Gray, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

044955 Issued in CT

Practice address

455 Boston Post Rd
Suite 10
Old Saybrook, CT 06475-1516

Phone

(860) 388-9799

Fax

(860) 388-6646

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Columbia University College of Physicians and Surgeons, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saybrook Dermatology LLCGroup PAC ID 4688663248, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Saybrook Dermatology LLC

  • Dermatology Physician
  • Old Saybrook, CT
  • NPI 1902909708
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1285644039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 BOSTON POST RD",
            "address_2": "SUITE 10",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751516",
            "telephone_number": "860-388-9799",
            "fax_number": "860-388-6646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 BOSTON POST RD",
            "address_2": "SUITE 10",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064751516",
            "telephone_number": "860-388-9799",
            "fax_number": "860-388-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "11512",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "044955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol E Gordon, OD
• Diane J Gracewski, LICSW
• Sarah Mairi Graham-Shaw
• Chelsea Wright Graham
• James Henry Gratton
• Jeffrey Alfonso Guance, LMSW
• Guiding Star Network, LLC
• Leonard G. Guitar, PSY.D.
• Harbor Home Care Co.
• Carla Harper, LPC

• Dermatology Physician in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.