Individual provider Active NPI

Andrea Michelle Wray, PA

  • Medical Physician Assistant
  • Oklahoma City, OK
National Provider Identifier
1619268901
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1958 Issued in OK
Practice address
9800 Broadway Ext Ste 203
Oklahoma City, OK 73114-6304
Phone
(405) 424-5415
Fax
(405) 424-5416
NPI assigned
Apr 21, 2011
Last updated
Jul 15, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1958 OK Primary

Addresses

Primary practice location

9800 Broadway Ext Ste 203
Oklahoma City, OK 73114-6304

Mailing address

9800 Broadway Ext Ste 203
Oklahoma City, OK 73114-6304
Phone (405) 424-5415

Other names 1

  • Miss Andrea Michelle Gilley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20110816000593 OK Practitioner - Physician Assistant 2668641226 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hpi Physicians LLCGroup PAC ID 6406048289, 48 clinicians

Practice addresses (Care Compare)

1616 S Kelly Ave
Edmond, OK 73013-3651
Phone (405) 341-8829

1705 S Renaissance Blvd
Suite 120
Edmond, OK 73013-3043
Phone (405) 715-4496

9800 Broadway Ext
Suite 203
Oklahoma City, OK 73114-6304

9800 Broadway Extension
Oklahoma City, OK 73114-6304

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Dec 1, 2018 Accepting new patients
Community Hospital LLC Past Accepting new patients

Locations

2017 W I 35 Frontage Rd
Ste 130
Edmond, OK 73013
Phone (405) 757-3630

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • Direct secure messaging: andreawray@okss.allscriptsdirect.net
  • Direct secure messaging: awray400084@direct.integrisok.com

Organizations & group practices 5

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 1

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1619268901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 BROADWAY EXT STE 203",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146304",
            "telephone_number": "405-424-5415",
            "fax_number": "405-424-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 BROADWAY EXT STE 203",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731146304",
            "telephone_number": "405-424-5415",
            "fax_number": "405-424-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRAY",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "GILLEY",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.