Individual provider Active NPI

Jonathan Joseph Gray, MD

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1295042687
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A118751 Issued in CA
Practice address
3626 Ruffin Rd
San Diego, CA 92123-1810
Phone
(858) 565-9666
Fax
(858) 565-9441
NPI assigned
Sep 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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 A118751 CA Primary

Addresses

Primary practice location

3626 Ruffin Rd
San Diego, CA 92123-1810

Mailing address

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (858) 565-9666

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140702000165 CA Practitioner - Anesthesiology 4587889787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Georgetown University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Service Medical GroupGroup PAC ID 1153223219, 236 clinicians

Practice addresses (Care Compare)

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (619) 565-9666

Hospital & facility affiliations

  • Sharp Memorial Hospital Hospital, San Diego, CA, CCN 050100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A118751CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Service Medical Group Anesthesiology CurrentSince Jul 1, 2014 Accepting new patients

Locations

3626 Ruffin Rd
San Diego, CA 92123
Phone (619) 565-9666

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Sharp Mesa Vista HospitalSan Diego, CA, CCN 054145 Hospital Corporate Director Oct 1, 2024
Sharp Memorial HospitalSan Diego, CA, CCN 050100 Hospital Corporate Director Oct 1, 2024
Sharp Memorial HospitalSan Diego, CA, CCN 05T100 Hospital Corporate Director Oct 1, 2024

Owned or controlled facilities with NPI records 3

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

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1295042687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JONATHAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-07",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A118751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.