SHANTELL S WRAY PA
NPI 1609966993
Physician Assistant in Groveland, FL

Q: What is Shantell Wray's NPI number?

The NPI number for Shantell Wray is 1609966993. It was assigned to this individual provider in the NPPES registry on October 15, 2006.

Q: What is Shantell Wray's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: Is Shantell Wray enrolled in Medicare?

No. Shantell Wray has opted out of Medicare through July 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Shantell Wray was last updated on October 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since October 15, 2006Opted out of Medicare · through Jul 1, 2028

1296 W BROAD ST, GROVELAND, FL 34736(407) 905-8827(352) 429-5606 Get Directions Write a Review

NPPES record last updated: October 3, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 3, 2022, May 24, 2021 (2 updates tracked since 2021).

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About Shantell S Wray Pa NPPES

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

SHANTELL S WRAY PA (NPI 1609966993) is an individual physician assistant in Groveland, Florida, licensed in Connecticut (002435) and active in the NPI registry since October 2006. She has opted out of Medicare through July 1, 2028, is affiliated with Orlando Health South Lake Hospital, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1609966993

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameSHANTELL S WRAYCredential: PA

Location Address1296 W BROAD STGroveland, FL 34736-2012

Mailing Address110 S Woodland StWinter Garden, FL 34787-3546 · (407) 905-8827 · Fax (407) 905-8998

Phone(407) 905-8827

Fax(352) 429-5606

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateOctober 15, 2006

Last NPPES UpdateOctober 3, 20222 updates tracked since enumeration

NPPES CertifiedOctober 3, 2022

✔ NPI 1609966993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CT · 002435

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1296 W BROAD ST, Groveland, FL 34736

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Other Identifiers 2

Other1071883Nccpa

Medicaid115500100FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, Wellpoint.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Shantell S Wray Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2026 through July 1, 2028.

Opt-Out Effective DateJuly 1, 2026

Opt-Out In Effect ThroughJuly 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

82 services48 patients

Hospital Affiliations CMS Care Compare

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

Orlando Health South Lake Hospital

Acute Care Hospitals · Clermont, FL

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100051

Location1900 Don Wickham DrClermont, FL 34711 · Lake County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34736 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

Other Providers at the Same Location NPPES 16

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

JANICE DARDEN KRIVAN ARNP

Nurse Practitioner (Pediatrics)