Individual provider Active NPI

Stacey Tutt Gray, M.D.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1407835929
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
226722 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3002
Phone
(617) 573-4188
NPI assigned
Jan 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 226722 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3002

Mailing address

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-4188

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000485 MA Practitioner - Otolaryngology 3678597358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Georgetown University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts Eye and Ear Associates, IncGroup PAC ID 4486540275, 430 clinicians

Practice addresses (Care Compare)

243 Charles St
Boston, MA 02114-3002
Phone (617) 523-7900

Hospital & facility affiliations

  • Massachusetts Eye and Ear Infirmary - Hospital, Boston, MA, CCN 220075
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101
  • Cooley Dickinson Hospital Inc,the Hospital, Northampton, MA, CCN 220015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226722MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Massachusetts Eye and Ear Associates, Inc. Otolaryngology Past Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

300 Crown Colony Dr
Ste 201
Quincy, MA 02169
Phone (617) 573-3135

Interoperability endpoints

  • Direct secure messaging: gray.stacey.meei@direct.partners.masshiway.net

Organizations & group practices 3

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 6

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1407835929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "STACEY",
        "middle_name": "TUTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-12",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "226722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.