Individual provider Active NPI

Geoffrey Lance Ray, M.D.

  • Radiation Oncology Physician
  • Holiday, FL
National Provider Identifier
1457589608
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
82190 Issued in SC
Practice address
3000 US Highway 19
Holiday, FL 34691-2635
Phone
(727) 942-7070
NPI assigned
Jun 26, 2009
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X ME124289 FL
Radiation Oncology Physician 2085R0001X 82190 SC Primary

Addresses

Primary practice location

3000 US Highway 19
Holiday, FL 34691-2635

Mailing address

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 497-8312

Other practice location 1

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 497-8312

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address GEOFFREY.RAY@hca5.eclinicaldirectplus.com
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161026000793 MD Practitioner - Radiation Oncology 3072750553 Reassigns benefits to 1 organization
I20220914000462 DC Practitioner - Radiation OncologyPractitioner - Diagnostic Radiology 3072750553 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation OncologyAlso: Diagnostic Radiology
Education
Howard University College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1221 Mercantile LN
Largo, MD 20774-5374
Phone (301) 618-5700

12255 Fair Lakes Pkwy
Fairfax, VA 22033-3952
Phone (703) 237-4800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore, Inc Radiation Oncology CurrentSince Nov 1, 2016 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Nov 1, 2016 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Mid Atlantic States, Inc CurrentSince Sep 6, 2022 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

2101 E Jefferson St
Ste 6WPPQA
Rockville, MD 20852
Phone (301) 816-5853

1221 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 618-5500

Interoperability endpoints

  • Direct secure messaging: geoffrey.ray@hca5.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1457589608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-497-8312",
            "fax_number": "843-497-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 US HIGHWAY 19",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346912635",
            "telephone_number": "727-942-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-497-8312",
            "fax_number": "843-497-8305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "GEOFFREY",
        "middle_name": "LANCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME124289",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "SC",
            "license": "82190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GEOFFREY.RAY@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "809 82nd Pkwy",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "809 82nd Pkwy",
            "city": "Myrtle Beach",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295724607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holiday, FL

Sources for this page

Verify at the official NPI Registry.