NPIMap

Individual provider Active NPI

Timothy J. Gray II, D.O.

  • Family Medicine Physician
  • Forest Grove, OR
National Provider Identifier
1699770057
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO23965 Issued in OR
Practice address
1909 Mountain View LN
Suite 200
Forest Grove, OR 97116-2893
Phone
(503) 359-4773
Fax
(503) 359-3809
NPI assigned
Jun 14, 2005
Last updated
Jul 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO23965 OR Primary

Addresses

Primary practice location

1909 Mountain View LN
Suite 200
Forest Grove, OR 97116-2893

Mailing address

PO Box 189
Forest Grove, OR 97116-0189
Phone (503) 359-4773

Other identifiers 1

IdentifierTypeStateIssuer
231406MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050117000329 OR Practitioner - Family Practice 8729037981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Timothy J Gray DO LLCGroup PAC ID 1355390584, 11 clinicians

Practice addresses (Care Compare)

4660 NE Belknap CT
Suite 119
Hillsboro, OR 97124-8402
Phone (503) 359-4773

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy J Gray DO LLC Family Medicine CurrentSince Apr 30, 2003 Accepting new patients

Locations

1909 Mountain View Ln
Ste 200
Forest Grove, OR 97116
Phone (503) 359-4773

4660 NE Belknap Ct
Ste 119
Hillsboro, OR 97124
Phone (503) 359-3809

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26386/brand/1/csg/1/fhir/r4
  • Direct secure messaging: timothy.gray.2@26386.direct.athenahealth.com

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1699770057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971160189",
            "telephone_number": "503-359-4773",
            "fax_number": "503-359-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 MOUNTAIN VIEW LN",
            "address_2": "SUITE 200",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162893",
            "telephone_number": "503-359-4773",
            "fax_number": "503-359-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO23965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231406",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Grove, OR

Sources for this page

Verify at the official NPI Registry.