Individual provider Active NPI

Leslie B. Gray, M.D.

  • Vascular Surgery Physician
  • Meridian, MS
National Provider Identifier
1295727766
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
15657 Issued in MS
Practice address
1800 12TH St
Meridian, MS 39301-4158
Phone
(601) 484-6700
NPI assigned
Aug 19, 2005
Last updated
May 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 15657 MS
Vascular Surgery Physician 2086S0129X 15657 MS Primary

Addresses

Primary practice location

1800 12TH St
Meridian, MS 39301-4158

Mailing address

PO Box 5183
Meridian, MS 39302-5183

Other identifiers 3

IdentifierTypeStateIssuer
009809700OtherALMEDICAID OF AL
020038463OtherRAILROAD MEDICARE
00119529MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20070419000465 MS Practitioner - General SurgeryPractitioner - Vascular Surgery 5395659429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Tulane University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 484-6700

1800 12TH St
Meridian, MS 39301-4158
Phone (601) 484-6700

2401 16TH St
Meridian, MS 39301-3950
Phone (601) 482-4181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.77 of 100Reported as individual
Quality
85
Improvement activities
0
Cost
76.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)15
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Foundation, Inc. CurrentSince Jan 11, 2017 Accepting new patients
Medical Foundation, Inc. CurrentSince Jan 11, 2017 Accepting new patients
Meridian Surgery Center, LLC PastSince Jan 5, 2004 Accepting new patients
Rush Medical Foundation Past Accepting new patients

Locations

1800 12th St
Meridian, MS 39301
Phone (601) 483-0011

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1295727766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 12TH ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014158",
            "telephone_number": "601-484-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LESLIE",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MS",
            "license": "15657",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "15657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF AL",
            "identifier": "009809700",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020038463",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00119529",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.