Jennifer Patricia Gray, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11034 Issued in MN

Practice address

2600 39TH Ave NE
Minneapolis, MN 55421-4379

Phone

(763) 581-5500

Fax

(763) 581-5501

NPI assigned

Nov 18, 2011

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

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Memorial Health CareGroup PAC ID 0042123028, 502 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
• Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jgray86147@direct.northmemorial.com

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.

• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Medicare reassignment Care Compare group
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1568893220
  NPD
• Centracare Clinic

  • Multi-Specialty Clinic/Center
  • Saint Cloud, MN
  • NPI 1225030844
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Maple Grove Hospital Corporation

  • General Acute Care Hospital
  • Maple Grove, MN
  • NPI 1225272552
  Care Compare affiliation
• North Memorial Health Care

  • Ambulance
  • Brooklyn Center, MN
  • NPI 1538195912

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Medical Specialty Clinic/Center
  • Robbinsdale, MN
  • NPI 1699953000

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • Clinic/Center
  • Blaine, MN
  • NPI 1841995552

  Hospital

  Care Compare affiliation
• North Memorial Health Care

  • General Acute Care Hospital
  • Robbinsdale, MN
  • NPI 1851344907
  Care Compare affiliation

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1477820405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 39TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554214379",
            "telephone_number": "763-581-5500",
            "fax_number": "763-581-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 39TH AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554214379",
            "telephone_number": "763-581-5500",
            "fax_number": "763-581-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "JENNIFER",
        "middle_name": "PATRICIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "1651",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "11034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Sydney Graves, PHARMD
• Gray Duck Mental Health
• Gray Therapy LLC
• Catherine Gray, MD
• Iosha B Gray
• Kasey Michael Gray, PTA
• Lisa Gray, MA LMFT
• Michelle Irene Gray
• Nicole Gray
• Raluca Gray, MD

• Physician Assistant in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.