Individual provider Active NPI

Nira L. Ray, MHS, PA-C

  • Physician Assistant
  • Danbury, CT
National Provider Identifier
1871617142
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6639 Issued in CT
Practice address
24 Hospital Ave
Danbury, CT 06810-6077
Phone
(203) 739-7000
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 6639 CT Primary

Addresses

Primary practice location

24 Hospital Ave
Danbury, CT 06810-6077

Mailing address

911 Lakeville St # 352
Petaluma, CA 94952-3329
Phone (415) 754-5584

Other practice location 1

911 Lakeville St # 352
Petaluma, CA 94952-3329
Phone (415) 754-5584

Other names 1

  • Ms. Nira L. Hinckle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050621000998 CA Practitioner - Physician Assistant 7911942974 Reassigns benefits to 1 organization
I20250224001792 CT Practitioner - Physician Assistant 7911942974

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Reserve Rd
Danbury, CT 06810-5212

24 Hospital Ave
Danbury, CT 06810-6077

Hospital & facility affiliations

  • Danbury Hospital Hospital, Danbury, CT, CCN 070033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Orthopaedic Medical Group, Inc. CurrentSince Mar 29, 2016 Accepting new patients
Gordon C. Lundy Past Accepting new patients
Firstcare Medical Foundation Physician Assistant Past Accepting new patients
Gordon C Lundy MD a Professional Corporation Past Accepting new patients
Paul D. Abramson, MD, Inc. PastSince Aug 17, 2009 Accepting new patients

Locations

1405 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 546-1922

Interoperability endpoints

  • Direct secure messaging: nray183922@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1871617142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 LAKEVILLE ST # 352",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523329",
            "telephone_number": "415-754-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106077",
            "telephone_number": "203-739-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Lakeville St # 352",
            "address_purpose": "LOCATION",
            "city": "Petaluma",
            "state": "CA",
            "postal_code": "949523329",
            "country_code": "US",
            "telephone_number": "415-754-5584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "NIRA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MHS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "6639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NIRA",
            "last_name": "HINCKLE",
            "middle_name": "L.",
            "prefix": "MS.",
            "credential": "MHS, PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.