Michael Gray, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA11821 Issued in CA

Practice address

625 Lincoln Ave
San Jose, CA 95126-3785

Phone

(408) 871-5260

Fax

(408) 871-3237

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1659481869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 RACE ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263518",
            "telephone_number": "408-278-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 LINCOLN AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263785",
            "telephone_number": "408-871-5260",
            "fax_number": "408-871-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MICHAEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA11821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0PA118210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Gray, MSW
• Hannah Regina Gray, MD
• Jacob Gray
• Katherine Virginia Gray, M.D.
• Mark E. Gray, D.C.
• Rachel Gray, MSN, FNP-BC
• Regina Gray, DDS
• Ryan Gray
• Savanah Gray
• Sheyanna Gray

• Medical Physician Assistant in San Jose, CA
• Providers in San Jose, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.