Andrea Gray, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A62009 Issued in CA

Practice address

250 Bon Air Rd
Greenbrae, CA 94904-1702

Phone

(415) 448-1500

Fax

(415) 461-4229

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• La Clinica de la Raza, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1427070374
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669553418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROFESSIONAL CENTER DR",
            "address_2": "SUITE 311",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949474334",
            "telephone_number": "415-448-1555",
            "fax_number": "415-892-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-448-1500",
            "fax_number": "415-461-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANDREA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A62009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Christine Gonzalves, M.S.W., A.S.W.
• Chad James Goodman, M.D.
• Flash Gordon, M.D.
• Jeremy Jayme Graham, RN, MSN, NP-C
• Tofani Grava, LMFT
• Greenbrae Care Center, LLC
• Greenbrae Dermatology, a Medical Corporation
• Greenbrae Surgery Center
• Greenbrae Surgery Center
• Greenbrae Surgery Center LLC

• Pediatrics Physician in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.