Peter J Gray, PA-C
Physician Assistant in Medford, OR. Individual provider (NPI-1).
NPI number1528037397
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1528037397
- Entity type
- Individual (NPI-1)
- Name
- Peter J Gray
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 15, 2006
- Last updated
- Mar 7, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA154108 | OR | Yes |
| 363A00000X | Physician Assistant | PA10003890 | WA |
Practice location
1600 Delta Waters RdSuite 107
Medford, OR 97504-9114
Phone 541-858-2515 · Fax 541-858-2514
Mailing address
815 N Central AveSuite C
Medford, OR 97501-5873
Phone 541-734-9030 · Fax 541-734-9885
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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