Individual provider Active NPI

Michael T Gray, M.D.

  • Infectious Disease Physician
  • Bay Shore, NY
National Provider Identifier
1477634350
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
201426 Issued in NY
Practice address
40 E Main St
Bay Shore, NY 11706-8301
Phone
(631) 376-6075
Fax
(631) 376-6091
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 201426 NY
Infectious Disease Physician 207RI0200X 201426 NY Primary

Addresses

Primary practice location

40 E Main St
Bay Shore, NY 11706-8301

Mailing address

125 Sunrise Hwy
West Islip, NY 11795-2023
Phone (631) 376-6075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080305000124 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 1759466436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Infectious Diseases Medicine PLLCGroup PAC ID 6608305966, 5 clinicians
South Shore Infectious Diseases , PCGroup PAC ID 6608951389, 5 clinicians

Practice addresses (Care Compare)

40 E Main St
Bay Shore, NY 11706-8301
Phone (631) 376-6075

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.07 of 100Reported as individual
Quality
56.69
Improvement activities
0
Cost
68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Diseases Medicine PLLC Infectious Disease CurrentSince Jan 1, 2025 Accepting new patients
South Shore Infectious Diseases , PC Specialist CurrentSince Sep 1, 2007 Accepting new patients

Locations

40 E Main St
Bay Shore, NY 11706
Phone (631) 376-6075

786 Montauk Hwy
West Islip, NY 11795
Phone (631) 376-6075

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 5

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1477634350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SUNRISE HWY",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952023",
            "telephone_number": "631-376-6075",
            "fax_number": "631-376-6091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068301",
            "telephone_number": "631-376-6075",
            "fax_number": "631-376-6091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "201426",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "201426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.