Individual provider Active NPI

Gray McCaffery, FNP-BC

  • Family Nurse Practitioner
  • Mystic, CT
National Provider Identifier
1992580294
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
012276 Issued in CT
Practice address
100 Perkins Farm Dr Ste 203
Mystic, CT 06355-4041
Phone
(201) 787-1446
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 012276 CT Primary

Addresses

Primary practice location

100 Perkins Farm Dr Ste 203
Mystic, CT 06355-4041

Mailing address

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (201) 787-1446

Other names 1

  • Gray Pendergast Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240215002684 CT Practitioner - Nurse Practitioner 2961846175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford Healthcare Medical Group IncGroup PAC ID 1153573902, 257 clinicians

Practice addresses (Care Compare)

324 Flanders Rd
East Lyme, CT 06333-1735
Phone (860) 739-6953

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
012276CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc CurrentSince Mar 15, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Past Accepting new patients
Hartford Healthcare Medical Group, Inc PastSince Feb 23, 2025 Accepting new patients
SVMC Holdings, Inc Past Accepting new patients

Locations

324 Flanders Rd
East Lyme, CT 06333
Phone (860) 739-1864

100 Perkins Farm Dr
Ste 203
Mystic, CT 06355
Phone (860) 572-8911

4 Shaws Cv
Ste 103
New London, CT 06320
Phone (860) 443-3778

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1025 Silas Deane Hwy
Ste 101
Wethersfield, CT 06109
Phone (877) 707-4442

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: gmccaffery524929@xdr.hhchealthdirect.org

Organizations & group practices 4

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 6

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1992580294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094337",
            "telephone_number": "201-787-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PERKINS FARM DR STE 203",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063554041",
            "telephone_number": "201-787-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAFFERY",
        "first_name": "GRAY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "012276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRAY",
            "last_name": "PENDERGAST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mystic, CT

Sources for this page

Verify at the official NPI Registry.