Individual provider Active NPI

Phillip John Gray Jr., M.D.

  • Radiation Oncology Physician
  • Stoneham, MA
National Provider Identifier
1801071725
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
249728 Issued in MA
Practice address
48 Montvale Ave
Stoneham, MA 02180-2425
Phone
(781) 279-0655
Fax
(781) 279-0409
NPI assigned
Jan 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 249728 MA Primary

Addresses

Primary practice location

48 Montvale Ave
Stoneham, MA 02180-2425

Mailing address

48 Montvale Ave
Stoneham, MA 02180-2425
Phone (781) 279-0655

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20140623001785 MA Practitioner - Radiation Oncology 6103084892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Johns Hopkins University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hallmark Health Medical Associates IncGroup PAC ID 4385638782, 151 clinicians

Practice addresses (Care Compare)

425 Revere St
Revere, MA 02151-4543
Phone (781) 665-6606

48 Montvale Ave
Stoneham, MA 02180-2425
Phone (781) 279-0655

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
249728MAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc CurrentSince May 1, 2016 Accepting new patients

Locations

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Interoperability endpoints

  • Direct secure messaging: pgray23942@tuftsmedicine.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1801071725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021802425",
            "telephone_number": "781-279-0655",
            "fax_number": "781-279-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 MONTVALE AVE",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021802425",
            "telephone_number": "781-279-0655",
            "fax_number": "781-279-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "PHILLIP",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-09",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "249728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.