DR. JILL MAVEN GRAY PSYD, LP
NPI 1124124045
Psychologist - Clinical in St Louis Park, MN
About Dr. Jill Maven Gray Psyd, Lp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JILL MAVEN GRAY PSYD, LP (NPI 1124124045) is an individual clinical provider in St Louis Park, Minnesota, licensed in Minnesota (LP3557) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, maintains a secondary practice location in Landfall Village, and is a graduate of Other (1996).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Secondary Practice Location 1
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jill Maven Gray Psyd, Lp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Jill Gray reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
St. Louis Park, MN 55416
- Reassigned Medicare billing, Minnesota enrollment
- 17 clinicians in this Medicare group
Anoka, MN 55303
- Reassigned Medicare billing, Minnesota enrollment
- 145 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Minnesota enrollment
- 98 clinicians in this Medicare group
Miami, FL 33130
- Reassigned Medicare billing, Minnesota enrollment
- 276 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55416 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ST. LOUIS PARK, MN 55416
ST LOUIS PARK, MN 55416
Frequently 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 Jill Gray's NPI number?
The NPI number for Jill Gray is 1124124045. It was assigned to this individual provider in the NPPES registry on September 16, 2006. The provider is also known as Dr. Jill Marie Adams LP.
Where is Jill Gray located?
Jill Gray practices at 4201 Excelsior Blvd, St Louis Park, MN 55416. The listed phone number is (952) 933-8900.
What is Jill Gray's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jill Gray enrolled in Medicare?
Yes. Jill Gray is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Jill Gray's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jill Gray reassigns Medicare benefits to 4 organizations: Minnesota Medical And Rehabilitative Services, LLC (St. Louis Park, MN), Family Innovations, Inc. (Anoka, MN), Mental Health Specialty Group PA (Durham, NC) and Grow Healthcare Group PA (Miami, FL). Each 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 Jill Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jill Gray was last updated on April 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Dr. Jill Maven Gray, PSYD, LP · NPI 1124124045
Clinical provider in St Louis Park, Minnesota. Individual provider, active in the CMS NPPES registry since September 16, 2006.
## Identity
- **NPI:** 1124124045 (Entity type: Individual)
- **Enumerated:** September 16, 2006
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** LP3557 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4201 EXCELSIOR BLVD, St Louis Park, MN 55416-4728
- **Phone:** (952) 933-8900 · **Fax:** (952) 945-9536
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Minnesota Medical And Rehabilitative Services, LLC (NPI 1154302545, St. Louis Park, MN); Family Innovations, Inc. (NPI 1992862783, Anoka, MN); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC); Grow Healthcare Group PA (NPI 1245845932, Miami, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1996
## Record status
- **NPPES last updated:** April 25, 2022
- **Other identifiers:** Other 61-56740 (MN); Medicaid 920215300 (MN); Other 996N6AJ (MN)
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Source: [NPI Profile](https://npiprofile.com/npi/1124124045) · Data from the CMS NPPES public registry.