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NICOLE GRAY
NPI 1275392003
Nurse Practitioner - Neonatal in Minneapolis, MN

Active since March 14, 2024PECOS Enrolled
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 365-1000 Get Directions Write a Review

NPPES record last updated: March 14, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Nicole Gray NPPES

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

NICOLE GRAY (NPI 1275392003) is an individual neonatal provider in Minneapolis, Minnesota, licensed in Minnesota (11394) and active in the NPI registry since March 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275392003
Entity TypeIndividualFemale
Primary Taxonomy363LN0000X
Provider Legal NameNICOLE GRAY
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address1486 309th Ln NeCambridge, MN 55008-6809 · (763) 244-5256
Phone(612) 365-1000
Sole ProprietorNo
Enumeration DateMarch 14, 2024
NPPES CertifiedMarch 14, 2024
✔ NPI 1275392003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · NeonatalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LN0000X
License✔ Licensed in MN · 11394
2450 RIVERSIDE AVE, Minneapolis, MN 55454
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Gray is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

6

Medicare enrollment records show Nicole Gray reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
Same address
Clinic/Center
2450 RIVERSIDE AVE, STE F140
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1841428745 (612) 672-6999
Fairview Health Services
Same address
General Acute Care Hospital
2450 RIVERSIDE AVE, OUTREACH LAB DEPARTMENT
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 4,038 clinicians in this Medicare group
NPI 1316008212 (612) 273-7838
Fairview Clinics
0.1 mi
Clinic/Center
606 24TH AVE S, STE 602
Minneapolis, MN 55454
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,302 clinicians in this Medicare group
NPI 1043516867 (612) 273-6099
Healtheast Medical Research Institute
3.3 mi
Internal Medicine
1700 UNIVERSITY AVE W, 6TH FLOOR WEST
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,361 clinicians in this Medicare group
NPI 1508191552 (651) 232-2273
Healtheast St. John's Hospital
3.3 mi
Anesthesiology
1700 UNIVERSITY AVE W
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 1,178 clinicians in this Medicare group
NPI 1558240853 (855) 324-7843
Healtheast Woodwinds Hospital
13 mi
General Acute Care Hospital
1925 WOODWINDS DR
Woodbury, MN 55125
  • Reassigned Medicare billing, Minnesota enrollment
  • 955 clinicians in this Medicare group
NPI 1356309322 (651) 232-0100

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55454 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MICHELLE IRENE GRAY
Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
DR. KATHLEEN F SADAK MD
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-6402
DR. ADMATHA MUTHYALA WINFRED MD
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
KELLY SCHELLER WILLIAMS
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-3216
MRS. MARY SUSAN CLIPP CPNP-AC
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 365-3100
DANIEL TESFAYE KEBED MD
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MS. CHELSEA ANJELICA MIELKE PA-C
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 672-6000
MRS. JESSICA LYNN MCADAM
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Hennepin County (612) 273-8383

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 Nicole Gray's NPI number?

The NPI number for Nicole Gray is 1275392003. It was assigned to this individual provider in the NPPES registry on March 14, 2024.

Where is Nicole Gray located?

Nicole Gray practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 365-1000.

What is Nicole Gray's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Neonatal, with taxonomy code 363LN0000X.

Is Nicole Gray enrolled in Medicare?

Yes. Nicole Gray is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicole Gray's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Gray reassigns Medicare benefits to 6 organizations: Fairview Express Care (Minneapolis, MN), Fairview Health Services (Minneapolis, MN), Fairview Clinics (Minneapolis, MN), Healtheast Medical Research Institute (Saint Paul, MN), Healtheast St. John's Hospital (Saint Paul, MN) and 1 more organization, listed in the Medicare section above. 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 Nicole Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Gray accept?

Health plans from Sanford Health Plan list Nicole Gray 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 Nicole Gray was last updated on March 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.