Theresa Gray, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1111-25 Issued in WI

Practice address

3522 W Lisbon Ave
Milwaukee, WI 53208-1953

Phone

(414) 935-8000

Fax

(414) 344-3350

NPI assigned

Jun 15, 2015

Last updated

Jun 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Community Health Centers IncGroup PAC ID 2466366059, 24 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tgray293944@direct.ochin.org

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.

• Progressive Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Milwaukee, WI
  • NPI 1720153653
  Medicare reassignment Care Compare group NPD
• Yomex LLC

  dba Milwaukee Advanced Foot & Ankle Clinic

  • Podiatric Clinic/Center
  • Milwaukee, WI
  • NPI 1295042711

  Podiatrist

  Medicare reassignment NPD
• Grayco LLC

  • Foot & Ankle Surgery Podiatrist
  • Mequon, WI
  • NPI 1225675697
  NPD Authorized official
• Yomex LLC

  dba Milwaukee Advanced Foot & Ankle Clinic

  • Podiatrist
  • Milwaukee, WI
  • NPI 1194123513
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1386025377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081953",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 N Mayfair Rd Ste 80",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "53226",
            "country_code": "US",
            "telephone_number": "414-326-9034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "1111-25",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WI",
            "license": "1111-25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100076793",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina Lashell Gray
• Kyonna Michelle Gray
• Patricia Louise Gray, 15653-130
• Quatina Gray
• Sarah Marie Gray
• Todd Gray, APNP
• Tyronda T Gray, APNP
• Richelle Grays
• Anthony F Graziano, M.D.
• Milan Grbic, PT

• Foot & Ankle Surgery Podiatrist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Foot & Ankle Surgery Podiatrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.