Individual provider Active NPI

Bryant Gray, D.O.

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1871947572
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB10592400 Issued in NJ
Practice address
201 Lyons Ave
Medical Education Department
Newark, NJ 07112-2027
Phone
(973) 926-3233
NPI assigned
Apr 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB10592400 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Medical Education Department
Newark, NJ 07112-2027

Mailing address

201 Lyons Ave # D-11
Newark, NJ 07112-2027

Other names 1

  • Dr. Bryant Gray Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20200818000822 VA Practitioner - Emergency Medicine 5890021463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lincoln Memorial University Medical Department, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

1500 Commonwealth Ave
Williamsburg, VA 23185-5229
Phone (757) 585-2250

Hospital & facility affiliations

  • Riverside Regional Medical Center Hospital, Newport News, VA, CCN 490052
  • Riverside Smithfield Hospital Hospital, Smithfield, VA, CCN 490149

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB10592400NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc CurrentSince Jul 1, 2020 Accepting new patients
Riverside Physician Services Inc Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

2244 Executive Dr
Hampton, VA 23666
Phone (757) 827-1001

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

Organizations & group practices 3

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1871947572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE # D-11",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "MEDICAL EDUCATION DEPARTMENT",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-19",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB10592400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRYANT",
            "last_name": "GRAY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.