Individual provider Active NPI

Joel Michael Grey, PA-C

  • Physician Assistant
  • Davis, CA
National Provider Identifier
1285989988
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14780 Issued in CA
Practice address
635 Anderson Rd Ste 10
Davis, CA 95616-3505
Phone
(530) 758-1122
NPI assigned
Jul 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14780 CA Primary

Addresses

Primary practice location

635 Anderson Rd Ste 10
Davis, CA 95616-3505

Mailing address

815 Garratt Lane
Ground Floor Flat
London, ENGLAND SW17 0PF
GB
Phone 011447804619318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121105000540 CA Practitioner - Physician Assistant 1355592031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

635 Anderson Rd
Suite 10
Davis, CA 95616-3505
Phone (530) 758-1122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14780CAMDProfessional Counselor
PA14780CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Physician Assistant CurrentSince Nov 19, 2012 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Nov 19, 2012 Accepting new patients
Sutter Regional Medical Foundation Physician Assistant Past Accepting new patients

Locations

635 Anderson Rd
Ste 10
Davis, CA 95616
Phone (530) 758-1122

2720 Low Ct
Fairfield, CA 94534
Phone (707) 428-2731

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: jgreypac13425@hisp.ehr.sutterhealth.org

Organizations & group practices 4

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 3

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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1285989988",
    "addresses": [
        {
            "country_code": "GB",
            "country_name": "Great Britain",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "815 GARRATT LANE",
            "address_2": "GROUND FLOOR FLAT",
            "city": "LONDON",
            "state": "ENGLAND",
            "postal_code": "SW17 0PF",
            "telephone_number": "011447804619318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD STE 10",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "530-758-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREY",
        "first_name": "JOEL",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.