NPIMap

Individual provider Active NPI

Daniel Stanley Gray, MD

  • Diagnostic Radiology Physician
  • Watertown, NY
National Provider Identifier
1851383343
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
206039-1 Issued in NY
Practice address
1571 Washington St
Suite 101
Watertown, NY 13601-9304
Phone
(315) 786-5000
Fax
(315) 786-5040
NPI assigned
Aug 19, 2005
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101279406 VA
Diagnostic Radiology Physician 2085R0202X 206039-1 NY Primary
Therapeutic Radiology Physician 2085R0203X 206039-1 NY

Addresses

Primary practice location

1571 Washington St
Suite 101
Watertown, NY 13601-9304

Mailing address

1571 Washington St
Suite 101
Watertown, NY 13601-9304
Phone (315) 786-5046

Other identifiers 1

IdentifierTypeStateIssuer
01747204MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC, VA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20100331001198 NY Practitioner - Diagnostic Radiology 3678653474 Reassigns benefits to 7 organizations
I20240301003123 NC Practitioner - Diagnostic Radiology 3678653474 Reassigns benefits to 2 organizations
I20240411001834 VA Practitioner - Diagnostic Radiology 3678653474

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Associates of South Carolina LLCGroup PAC ID 3779932959, 109 clinicians
Centra Medical Group LLCGroup PAC ID 4789606088, 709 clinicians
Raleigh Radiology Associates IncGroup PAC ID 6800874611, 58 clinicians
Radiology Associates of the Main Line P CGroup PAC ID 9931097193, 80 clinicians

Practice addresses (Care Compare)

37171 Nys Route 12
Clayton, NY 13624-2252
Phone (469) 757-1042

37171 State Route 12E
Clayton, NY 13624-2252
Phone (434) 200-5047

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
206039-1NYMDTherapeutic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Medical Center CurrentSince Feb 21, 2023 Accepting new patients
Samaritan Medical Center CurrentSince Feb 21, 2023 Accepting new patients
Centra Medical Group, LLC CurrentSince Aug 16, 2023 Accepting new patients
Raleigh Radiology Wakemed Imaging, LLC Diagnostic Radiology CurrentSince Jan 20, 2024 Accepting new patients
Raleigh Radiology, LLC Diagnostic Radiology CurrentSince Jan 20, 2024 Accepting new patients

Locations

150 Parkway Office Ct
Ste 100
Cary, NC 27518

1900 Kildaire Farm Rd
Cary, NC 27518
Phone (919) 350-2300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3200 Blue Ridge Rd
Ste 100
Raleigh, NC 27612
Phone (919) 256-3576

5220 Greens Dairy Rd
Raleigh, NC 27616
Phone (540) 493-4581

11640 Northpark Dr
Ste 110
Wake Forest, NC 27587

10881 US Route 11
Adams, NY 13605
Phone (315) 232-4400

629 Washington St
Watertown, NY 13601
Phone (315) 755-3650

830 Washington St
Watertown, NY 13601
Phone (315) 785-4000

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

320 Hospital Dr
Martinsville, VA 24112
Phone (276) 666-7200

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

Organizations & group practices 10

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": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1851383343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-786-5046",
            "fax_number": "315-786-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1571 WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136019304",
            "telephone_number": "315-786-5000",
            "fax_number": "315-786-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DANIEL",
        "middle_name": "STANLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101279406",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "206039-1",
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "NY",
            "license": "206039-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01747204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

Verify at the official NPI Registry.