NPIMap

Individual provider Active NPI

Charles Ray, MD

  • Diagnostic Radiology Physician
  • Aurora, CO
National Provider Identifier
1902915515
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
13593071-1205 Issued in UT
Practice address
12605 E 16TH Ave
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Aug 29, 2006
Last updated
Dec 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 13593071-1205 UT Primary
Vascular & Interventional Radiology Physician 2085R0204X 37917 CO

Addresses

Primary practice location

12605 E 16TH Ave
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Other identifiers 1

IdentifierTypeStateIssuer
65828551MedicaidCO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cray687381@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, UT2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140520001074 IL Practitioner - Interventional Radiology 3375516271 Reassigns benefits to 1 organization
I20240413000181 UT Practitioner - Diagnostic Radiology 3375516271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rush Medical College of Rush University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37917COMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Jan 6, 2014 Accepting new patients
University of Utah Adult Services Current Accepting new patients
The Board of Trustees of the University of Illinois Diagnostic Radiology CurrentSince Jan 6, 2014 Accepting new patients
University of Utah Adult Services CurrentSince Mar 2, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
University of Utah Adult Services Diagnostic Radiology CurrentSince Mar 2, 2024 Accepting new patients

Locations

1740 W Taylor St
#931
Chicago, IL 60612
Phone (312) 355-5258

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

127 S 500 E
Ste 400
Salt Lake City, UT 84102

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1902915515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12605 E 16TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "13593071-1205",
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CO",
            "license": "37917",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65828551",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cray687381@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.