DR. THERESA GRAY DPM
NPI 1386025377
Podiatrist - Foot & Ankle Surgery in Milwaukee, WI

NPI Status: Active since June 15, 2015

Contact Information

3522 W LISBON AVE
MILWAUKEE, WI
ZIP 53208
Phone: (414) 935-8000
Fax: (414) 344-3350

NPI Profile Information
Primary Taxonomy
Secondary Taxonomies
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 11
Podiatrist
Foot & Ankle Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled

About THERESA GRAY

This page provides the complete NPI Profile along with additional information for Theresa Gray, a provider established in Milwaukee, Wisconsin with a medical specialization in Podiatrist, focusing in foot & ankle surgery and more than 11 years of experience. She graduated from Kent State University College Of Podiatric Medicine in 2015. The healthcare provider is registered in the NPI registry with number 1386025377 assigned on June 2015. The practitioner's primary taxonomy code is 213ES0103X with license number 1111-25 (WI). The provider is registered as an individual and her NPI record was last updated 6 years ago.

NPI: 1386025377
Provider Name: DR. THERESA GRAY DPM
Gender: Female
Entity Type: Individual
Location Address: 3522 W LISBON AVE MILWAUKEE, WI 53208
Location Phone: (414) 935-8000
Location Fax: (414) 344-3350
Mailing Address: 3522 W LISBON AVE MILWAUKEE, WI 53208
Mailing Phone: (414) 935-8000
Mailing Fax: (414) 344-3350
Medical School Name: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year: 2015
Is Sole Proprietor?: No
Enumeration Date: 06-15-2015
Last Update Date: 06-22-2020
Code Navigator

Location Map

Secondary Locations

2525 N Mayfair Rd Ste 80
Wauwatosa, WI 53226
(414) 326-9034

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Podiatrist Foot & Ankle Surgery
Taxonomy Code: 213ES0103X
Type: Podiatric Medicine & Surgery Service Providers
License No.: 1111-25
License State: WI

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No.	Taxonomy Code	Type	Classification / Specialization	License No. (State)
1	213E00000X	Podiatric Medicine & Surgery Service Providers	Podiatrist	1111-25 (WI)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Anthem Blue Cross and Blue Shield

Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

CareSource (Common Ground Healthcare)

CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
CareSource (Common Ground Healthcare) Gold $3300 - EPO
CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO

Network Health

Prestige Bronze $0 Medical Deductible - HMO
Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
Prestige Bronze Essential + 3 Free PCP Visits - HMO
Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
Prestige Bronze Plus - HMO
Prestige Gold - HMO
Prestige Gold 50 + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO

Quartz

QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO

UnitedHealthcare

UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
UHC Bronze Standard (No Referrals) - HMO
UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Gold Standard (No Referrals) - HMO
UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
UHC Silver Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
100076793	MEDICAID (05)	WI

Medicare Participation & PECOS Enrollment Status

Theresa Gray is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Theresa Gray is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 2860756145
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20180514003038
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1386025377, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 16 → 1 + 6

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 10 → 1 + 0

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 0 → 0 5 → 10 → 1 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 6 + 6 + 0 + 2 + 1 + 0 + 3 + 1 + 4 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7

This NPI is valid

The calculated check digit is 7, which matches the last digit of 1386025377.