Individual provider Active NPI

Shrusan Gray, MD

  • Obstetrics & Gynecology Physician
  • Hollywood, FL
National Provider Identifier
1891951323
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME101946 Issued in FL
Practice address
4700 Sheridan St Unit U
Hollywood, FL 33021-3420
Phone
(954) 505-4458
Fax
(954) 367-3495
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME101946 FL Primary

Addresses

Primary practice location

4700 Sheridan St Unit U
Hollywood, FL 33021-3420

Mailing address

4700 Sheridan St Unit U
Hollywood, FL 33021-3420
Phone (954) 505-4458

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20090113000668 FL Practitioner - Obstetrics/Gynecology 1557424868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Obstetrics & Gynecology CurrentSince Jun 1, 2020 Accepting new patients
Florida Woman Care, LLC Obstetrics & Gynecology Past Accepting new patients

Locations

4700 Sheridan St
Unit U
Hollywood, FL 33021
Phone (954) 505-4458

4700 Sheridan St
Ste U
Hollywood, FL 33021
Phone (954) 505-4458

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

Interoperability endpoints

  • Direct secure messaging: shrusan.gray@toplinemd.eclinicaldirectplus.com
  • Direct secure messaging: sgray14301@mhsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1891951323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN ST UNIT U",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213420",
            "telephone_number": "954-505-4458",
            "fax_number": "954-367-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SHERIDAN ST UNIT U",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213420",
            "telephone_number": "954-505-4458",
            "fax_number": "954-367-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SHRUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME101946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.