JACKSON GRAY PHD
NPI 1497371652
Clinical Neuropsychologist in Baltimore, MD
About Jackson Gray Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON GRAY PHD (NPI 1497371652) is an individual clinical neuropsychologist in Baltimore, Maryland, licensed in Maryland (06711) and active in the NPI registry since June 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Columbus, and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
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
Jackson Gray Phd 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 Reassignment
Medicare enrollment records show Jackson Gray reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Richland, WA 99352
- Reassigned Medicare billing, Washington enrollment
- Medicare enrollment name: The Association Of Chrmc And University Physicians
- 1,443 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.
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.
BALTIMORE, MD 21231
BALTIMORE, MD 21231
BALTIMORE, MD 21231
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 Jackson Gray's NPI number?
The NPI number for Jackson Gray is 1497371652. It was assigned to this individual provider in the NPPES registry on June 23, 2020.
Where is Jackson Gray located?
Jackson Gray practices at 1750 E Fairmount Ave, Baltimore, MD 21231. The listed phone number is (920) 621-7263.
What is Jackson Gray's specialty?
The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.
Is Jackson Gray enrolled in Medicare?
Yes. Jackson 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 organization bills Medicare for Jackson Gray's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jackson Gray reassigns Medicare benefits to Association Of Chmc And University Physicians (Richland, WA). The 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 Jackson Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jackson Gray accept?
Health plans from Ambetter Health, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jackson 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 Jackson Gray was last updated on August 11, 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.
# Jackson Gray, PHD · NPI 1497371652
Clinical Neuropsychologist provider in Baltimore, Maryland. Individual provider, active in the CMS NPPES registry since June 23, 2020.
## Identity
- **NPI:** 1497371652 (Entity type: Individual)
- **Enumerated:** June 23, 2020
- **Primary specialty:** Clinical Neuropsychologist · taxonomy 103G00000X
- **State license:** 06711 (Maryland)
- **Sole proprietor:** No
## Practice location
- **Address:** 1750 E FAIRMOUNT AVE, Baltimore, MD 21231-1534
- **Phone:** (920) 621-7263
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Association Of Chmc And University Physicians (NPI 1851680664, Richland, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** August 11, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1497371652) · Data from the CMS NPPES public registry.