KEITH A GRAY MD PA
NPI 1720090749
Internal Medicine in Orlando, FL
About Keith A Gray Md Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEITH A GRAY MD PA (NPI 1720090749) is a healthcare organization registered as an internal medicine in Orlando, Florida and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through June 29, 2028 and lists Wisteria Y Wyche, Office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Keith A Gray Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Keith A Gray MD PA, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 10D0948042
Keith A Gray MD PA · Orlando, FLFrequently 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 Keith A Gray MD PA's NPI number?
The NPI number for Keith A Gray MD PA is 1720090749. It was assigned to this organization in the NPPES registry on August 12, 2006.
Where is Keith A Gray MD PA located?
Keith A Gray MD PA is located at 100 W Gore St Suite 303, Orlando, FL 32806. The listed phone number is (407) 423-9920.
What is Keith A Gray MD PA's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Keith A Gray MD PA enrolled in Medicare?
Yes. Keith A Gray MD PA is registered in the Medicare PECOS enrollment system.
When is Keith A Gray MD PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Keith A Gray MD PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Keith A Gray MD PA, in Internal Medicine and Nurse Practitioner. A 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 the clinician's services. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Keith A Gray MD PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 10D0948042) is associated with this NPI, valid through June 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Keith A Gray MD PA was last updated on April 20, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Keith A Gray Md Pa · NPI 1720090749
Internal Medicine organization in Orlando, Florida. Organization record, active in the CMS NPPES registry since August 12, 2006.
## Identity
- **NPI:** 1720090749 (Entity type: Organization)
- **Enumerated:** August 12, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Wisteria Wyche, OFFICE MANAGER
## Practice location
- **Address:** 100 W GORE ST, SUITE 303, Orlando, FL 32806-1044
- **Phone:** (407) 423-9920 · **Fax:** (407) 423-0545
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Florida, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Internal Medicine (1); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 20, 2011
- **Other identifiers:** Medicare UPIN D55109 (FL); Medicare ID-Type Unspecified K0404 (FL); Other 47582 (FL); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1720090749) · Data from the CMS NPPES public registry.