Bradley Wayne Gray, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-10753 Issued in AR

Practice address

2170 South Ave
South Lake Tahoe, CA 96150-7026

Phone

(530) 541-3420

NPI assigned

Mar 26, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV, CA2 enrollments

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 2

Specialty

HospitalistAlso: Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barton Healthcare SystemGroup PAC ID 1850293960, 24 clinicians

Barton Medical FoundationGroup PAC ID 5395127682, 97 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barton Memorial Hospital Hospital, South Lake Tahoe, CA, CCN 050352

Merit-based Incentive Payment System (MIPS)

Final score

98.59 of 100Reported as group

Quality

95.23

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

95.71 of 100Reported as apm

Quality

89.85

Promoting interoperability

94.05

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgray150835@direct.renown.org

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.

• Barton Healthcare System

  • Internal Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1235196015

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Barton Medical Foundation

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1750950499
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of California, Inc

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1184663965

  Family Medicine

  Medicare reassignment NPD
• Inpatient Specialists of California, PC

  • Internal Medicine Physician
  • San Bernardino, CA
  • NPI 1952792475

  Family Medicine

  Medicare reassignment NPD
• Tahoe Carson Valley Medical Group Inc

  • Family Medicine Physician
  • South Lake Tahoe, CA
  • NPI 1508865528
  Medicare reassignment NPD
• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752
  Medicare reassignment NPD
• Barton Healthcare System

  • Diagnostic Radiology Physician
  • Stateline, NV
  • NPI 1467046102
  NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Charleston Area Medical Center, Inc.

  • Community/Retail Pharmacy
  • Charleston, WV
  • NPI 1912247750
  NPD
• Barton Healthcare System

  • Home Health Agency
  • South Lake Tahoe, CA
  • NPI 1356348890
  NPD (past)
• St Marys Physician Services, LLC

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)

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

• Barton Healthcare System

  • General Acute Care Hospital
  • South Lake Tahoe, CA
  • NPI 1003867565
  Care Compare affiliation

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1851785976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-964-4178",
            "fax_number": "479-964-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-601-2015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1808 W Main St",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "72801",
            "country_code": "US",
            "telephone_number": "479-964-4178",
            "fax_number": "479-964-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "BRADLEY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-10753",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-10753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kevin Jason Gregerson, RPH
• Ross W. Groelz, DDS

• Family Medicine Physician in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.