Individual provider Active NPI

Levi Benjamin Gray, PA

  • Surgical Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1427624253
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4371 Issued in TN
Practice address
2525 Desales Ave
Chattanooga, TN 37404-1161
Phone
(423) 667-5783
Fax
(423) 495-6286
NPI assigned
Jun 2, 2021
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC052 KY
Surgical Physician Assistant 363AS0400X 4371 TN Primary

Addresses

Primary practice location

2525 Desales Ave
Chattanooga, TN 37404-1161

Mailing address

1949 Gunbarrel Rd Ste 206
Chattanooga, TN 37421-7133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220524000384 TN Practitioner - Physician Assistant 9032596432 Reassigns benefits to 1 organization
I20240618002407 ME Practitioner - Physician Assistant 9032596432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Suite 330
Bangor, ME 04401-6638
Phone (207) 973-8881

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Health Partners Foundation Inc CurrentSince May 1, 2022 Accepting new patients
Eastern Maine Medical Center CurrentSince Jul 28, 2024 Accepting new patients
Memorial Health Partners Foundation, Inc CurrentSince May 1, 2022 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

1949 Gunbarrel Rd
Ste 206
Chattanooga, TN 37421
Phone (423) 495-4345

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

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 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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1427624253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 GUNBARREL RD STE 206",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374217133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041161",
            "telephone_number": "423-667-5783",
            "fax_number": "423-495-6286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "LEVI",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC052",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.