Bianca Faith Gray, D.O.

Individual provider Active NPI Family Medicine Physician · Bisbee, AZ

NPI 1376779256 · NPPES record last updated Feb 27, 2015

Key facts

NPI
1376779256
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
H73482 (MD)
Practice address
10524 E Highway 92
Bisbee, AZ 85603
Phone
(520) 432-2042
Fax
(520) 432-2098
NPI assigned
Jun 4, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

Hospital & facility affiliations

  • Home Health Safford, LLC Home health agency · Safford, AZ · CCN 037815

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150122001205 AZ Practitioner - Family Practice 2860645637 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Bisbee Hospital Association Current
since Dec 1, 2014
Accepting new patients
Bisbee Hospital Association Current
since Dec 1, 2014
Accepting new patients

Locations

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

Interoperability endpoints

  • Direct secure messaging: biancagray@cqch.cernerdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H73482 MD Yes

Addresses

Primary practice location

10524 E Highway 92
Bisbee, AZ 85603

Mailing address

101 Cole Ave
Bisbee, AZ 85603-1327
Phone (520) 432-2042

Other providers in Bisbee, AZ

All providers in Bisbee, AZ · Family Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.