Individual provider Active NPI

David F Gray, LCSW

  • Clinical Social Worker
  • Amherst, NY
National Provider Identifier
1821094095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R022709 Issued in NY
Practice address
85 Bryant Woods S
Amherst, NY 14228-3604
Phone
(716) 689-3333
Fax
(716) 689-9866
NPI assigned
Jun 22, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R022709 NY Primary

Addresses

Primary practice location

85 Bryant Woods S
Amherst, NY 14228-3604

Mailing address

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

Other identifiers 5

IdentifierTypeStateIssuer
000505677007OtherNYHEALTH INTEGRATED
000505677007OtherNYBC/BS OF WNY
10767996OtherNYCAQH
6290332OtherNYINDEPENDENT HEALTH
00025664801OtherNYUNIVERA HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000625 NY Practitioner - Clinical Social Worker 7810170891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suburban Psychiatric Associates, LLPGroup PAC ID 6709774318, 35 clinicians

Practice addresses (Care Compare)

85 Bryant Woods S
Amherst, NY 14228-3604
Phone (716) 689-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R022709NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Psychiatric Associates, LLP CurrentSince Jan 1, 2002 Accepting new patients

Locations

85 Bryant Woods S
Buffalo, NY 14228
Phone (716) 689-3333

Interoperability endpoints

  • Direct secure messaging: dgray@spa.medentdirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821094095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BRYANT WOODS S",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283604",
            "telephone_number": "716-689-3333",
            "fax_number": "716-689-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BRYANT WOODS S",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142283604",
            "telephone_number": "716-689-3333",
            "fax_number": "716-689-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DAVID",
        "middle_name": "F",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R022709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH INTEGRATED",
            "identifier": "000505677007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF WNY",
            "identifier": "000505677007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10767996",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6290332",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA HEALTHCARE",
            "identifier": "00025664801",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NY

Sources for this page

Verify at the official NPI Registry.