GRAY DERM PLLC
NPI 1104392679
Dermatology in Lima, OH
About Gray Derm Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRAY DERM PLLC (NPI 1104392679), doing business as Gray Derm Llc, is a healthcare organization registered as a dermatology in Lima, Ohio and active in the NPI registry since October 2018. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Bryan Gray, Do/practice Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 2
Secondary Practice Locations 2
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gray Derm Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Gray Derm PLLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 8 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 3
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 36D2237051
Gray Dermatology & Cosmetic Surgery · Lancaster, OHCertificate of Compliance 36D2174852
Gray Dermatology & Cosmetic Surgery Of Lima · Lima, OHCertificate of Compliance 36D0994541
Gray Dermatology & Cosmetic Surgery · Lima, OHFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gray Derm PLLC's NPI number?
The NPI number for Gray Derm PLLC is 1104392679. It was assigned to this organization in the NPPES registry on October 22, 2018. The provider is doing business as Gray Derm LLC and Gray Dermatology & Cosmetic Surgery.
Where is Gray Derm PLLC located?
Gray Derm PLLC is located at 750 W High St Ste 300, Lima, OH 45801. The listed phone number is (419) 229-6781.
What is Gray Derm PLLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Gray Derm PLLC enrolled in Medicare?
Yes. Gray Derm PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Gray Derm PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 3 Medicare specialties reassign their Medicare billing to Gray Derm PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (6), Certified Clinical Nurse Specialist (CNS) (1) and Dermatology (1). Of these, 6 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Gray Derm PLLC hold CLIA laboratory certificates?
Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Gray Derm PLLC accept?
Health plans from Anthem Blue Cross and Blue Shield and Molina Healthcare list Gray Derm PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Gray Derm PLLC was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gray Derm Pllc · NPI 1104392679
Dermatology organization in Lima, Ohio. Organization record, active in the CMS NPPES registry since October 22, 2018.
## Identity
- **NPI:** 1104392679 (Entity type: Organization)
- **Enumerated:** October 22, 2018
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Also known as:** Gray Derm LLC (Doing Business As); Gray Dermatology & Cosmetic Surgery (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Bryan Gray, DO/PRACTICE OWNER
## Practice location
- **Address:** 750 W HIGH ST STE 300, Lima, OH 45801-2967
- **Phone:** (419) 229-6781 · **Fax:** (614) 386-9506
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Certified Clinical Nurse Specialist (CNS) (1), Dermatology (1); 6 practice at this address and 8 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 4, 2026
- **Other identifiers:** Other 34.013501 (OH); Other 5101021720 (MI)
- **CLIA laboratory certificates:** 3 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104392679) · Data from the CMS NPPES public registry.