Individual provider Active NPI

Thomas Brent Ray, DPM

  • Foot & Ankle Surgery Podiatrist
  • Waycross, GA
National Provider Identifier
1679735336
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PODPOD001158 Issued in GA
Practice address
501 W Oneida St
Waycross, GA 31501-5337
Phone
(912) 283-6471
Fax
(912) 283-6471
NPI assigned
Jun 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PODPOD001158 GA Primary

Addresses

Primary practice location

501 W Oneida St
Waycross, GA 31501-5337

Mailing address

501 W Oneida St
Waycross, GA 31501-5337
Phone (912) 283-6471

Other identifiers 2

IdentifierTypeStateIssuer
P00949916OtherRAILROAD MEDICARE
003108317AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110609000108 GA Practitioner - Podiatry 6103003645 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ankle and Foot Assoc LLCGroup PAC ID 1355327107, 20 clinicians

Practice addresses (Care Compare)

501 W Oneida St
Waycross, GA 31501-5337

501 W Oneida St
Waycross, GA 31501-6209
Phone (912) 283-6471

Hospital & facility affiliations

  • Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue60
Removal of skin lesions45
Removal of nail tissue968
Removal or shaving of skin growth533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PODPOD001158GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle & Foot Associates, LLC Foot & Ankle Surgery CurrentSince Jun 15, 2011 Accepting new patients

Locations

2140 Kingsley Ave
Ste 12
Orange Park, FL 32073
Phone (904) 272-7070

10 Professional Dr
Brunswick, GA 31520
Phone (912) 264-6150

501 Kings Bay Rd
Kingsland, GA 31548
Phone (912) 576-2471

501 W Oneida St
Waycross, GA 31501
Phone (912) 283-6471

Interoperability endpoints

  • Direct secure messaging: thomas.ray@afal.eclinicaldirectplus.com

Organizations & group practices 3

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 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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1679735336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W ONEIDA ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015337",
            "telephone_number": "912-283-6471",
            "fax_number": "912-283-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W ONEIDA ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015337",
            "telephone_number": "912-283-6471",
            "fax_number": "912-283-6471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "THOMAS",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-25",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "PODPOD001158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00949916",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108317A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.