TIMOTHY J GRAY M.D.
NPI 1215984752
Orthopaedic Surgery in Effingham, IL

Active since May 30, 2006PECOS EnrolledAccepts Medicare Assignment
91.8/100
CMS Quality Rating
1303 W EVERGREEN AVE STE 200, EFFINGHAM, IL 62401(217) 342-3400(217) 342-3477 Get Directions Write a Review

NPPES record last updated: January 26, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 26, 2022, Mar 16, 2020, Mar 4, 2019 and 3 more (6 updates tracked since 2017).

About Timothy J Gray M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY J GRAY M.D. (NPI 1215984752) is an individual orthopaedic surgery provider in Effingham, Illinois, licensed in Illinois (036082647) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and maintains a secondary practice location in Shelbyville.

NPPES Registry Identity

NPI1215984752
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameTIMOTHY J GRAYCredential: M.D.
Location Address1303 W EVERGREEN AVE STE 200Effingham, IL 62401-1638
Mailing Address1005 Health Center Dr Ste 201Mattoon, IL 61938-4653 · (217) 868-2812 · Fax (217) 258-2216
Fax(217) 342-3477
Sole ProprietorNo
Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 1988
Enumeration DateMay 30, 2006
Last NPPES UpdateJanuary 26, 20226 updates tracked since enumeration
NPPES CertifiedJanuary 26, 2022
NPI 1215984752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License Licensed in IL · 036082647
Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1303 W EVERGREEN AVE STE 200, Effingham, IL 62401

Secondary Practice Location 1

Location 11215 W Main StShelbyville, IL 62565-1252 · Phone (217) 774-4305 · Fax (217) 774-4306

Other Identifiers 2

Other227129IL · Healthlink
Medicaid036082647IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Timothy J Gray M.d. 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.

PECOS PAC ID1759411507
PECOS Enrollment IDI20100604001010
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
121 services91 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
107 services87 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
55 services55 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
42 services30 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
36 services36 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
20 services20 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number140032
Location503 N Maple StreetEffingham, IL 62401 · Effingham County
Emergency services Birthing friendly

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140189
Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County
Emergency services Birthing friendly

Fayette County Hospital

Critical Access Hospitals · Vandalia, IL
OwnershipVoluntary non-profit - Other
CMS Certification Number141346
Location650 W Taylor StVandalia, IL 62471 · Fayette County
Emergency services

Clay County Hospital

Critical Access Hospitals · Flora, IL
OwnershipGovernment - Local
CMS Certification Number141351
Location911 Stacy Burk DrFlora, IL 62839 · Clay County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62401 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.8/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality75.59
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,904 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
93%845 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
65%292 patients3/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%644 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
53%1,012 patients3/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
77%305 patients4/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
54%692 patients3/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
78%181 patients4/55-star benchmark: 88%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 60% · 390 patients
Patients tobacco: 59% · 390 patients
94%48 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
71%1,012 patients3/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
0%1,012 patients1/55-star benchmark: 89%
Use of High-Risk Medications in the Elderly
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication.
Lower rates are better for this measure.
Patients 2+: 0% · 305 patients
2%305 patients4/55-star benchmark: 100%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
1%1,012 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Physician Assistant
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Physician Assistant
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Nurse Practitioner (Family)
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401
Orthopaedic Surgery
1303 W EVERGREEN AVE STE 200
EFFINGHAM, IL 62401

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 Timothy Gray's NPI number?

The NPI number for Timothy Gray is 1215984752. It was assigned to this individual provider in the NPPES registry on May 30, 2006.

Where is Timothy Gray located?

Timothy Gray practices at 1303 W Evergreen Ave Ste 200, Effingham, IL 62401. The listed phone number is (217) 342-3400.

What is Timothy Gray's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Timothy Gray enrolled in Medicare?

Yes. Timothy 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.

Is Timothy Gray affiliated with any hospitals?

According to CMS data, Timothy Gray is affiliated with St Anthonys Memorial Hospital, Sarah Bush Lincoln Health Center, Fayette County Hospital and Clay County Hospital.

When was this NPI record last updated?

The NPPES record for Timothy Gray was last updated on January 26, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.