Individual provider Active NPI

Sean Gray, CNP

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1376080648
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2287152 Issued in MA
Practice address
55 Fruit St Ste 230
Boston, MA 02114-2621
Phone
(617) 726-2740
NPI assigned
Jan 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN2287152 MA
Nurse Practitioner 363L00000X RN2287152 MA Primary

Addresses

Primary practice location

55 Fruit St Ste 230
Boston, MA 02114-2621

Mailing address

55 Fruit St Ste 230
Boston, MA 02114-2621
Phone (617) 726-2740

Other practice location 1

33 Beechwood St
Quincy, MA 02169-5805
Phone (617) 827-4430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20181002003305 MA Practitioner - Nurse Practitioner 5799037727 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

101 Main St
Medford, MA 02155-4530
Phone (781) 395-4761

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

71 Needham St
Newton, MA 02461-1663
Phone (857) 598-4460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2287152MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Urgent Care LLC CurrentSince Oct 8, 2022 Accepting new patients
Mass General Brigham Urgent Care LLC Current Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Oct 8, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Sep 1, 2018 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Apr 1, 2026 Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2018 Accepting new patients
Massachusetts General Hospital Oral & Maxillofacial Surgery Past Accepting new patients
Mass General Brigham Community Physicians Inc. Past Accepting new patients

Locations

55 Fruit St
Ste 230
Boston, MA 02114
Phone (617) 726-2740

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

101 Main St
Ste 107
Medford, MA 02155
Phone (781) 391-4004

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

71 Needham St
Newton, MA 02461
Phone (617) 712-2770

Interoperability endpoints

  • Direct secure messaging: gray.sean.puc@direct.partners.masshiway.net

Organizations & group practices 8

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1376080648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST STE 230",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST STE 230",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-2740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Beechwood St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021695805",
            "country_code": "US",
            "telephone_number": "617-827-4430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2287152",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2287152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.