DEETTA GRAY M.D., FAAD, FRCPC
NPI 1790825966
Dermatology in Bellevue, WA
About Deetta Gray M.d., Faad, Frcpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DEETTA GRAY M.D., FAAD, FRCPC (NPI 1790825966) is an individual dermatology provider in Bellevue, Washington, licensed in Washington (025209 MD00035417) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1990).
NPPES Registry Identity
Specialties & Licenses
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
Deetta Gray M.d., Faad, Frcpc 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 Deetta Gray reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Salem, OR 97302
- Reassigned Medicare billing, Washington enrollment
- 59 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.
Areas of Expertise CMS Part B claims 6
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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 18
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BELLEVUE, WA 98004
BELLEVUE, WA 98004
BELLEVUE, WA 98004
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 Deetta Gray's NPI number?
The NPI number for Deetta Gray is 1790825966. It was assigned to this individual provider in the NPPES registry on February 7, 2007.
Where is Deetta Gray located?
Deetta Gray practices at 1515 116th Ave NE Ste 307, Bellevue, WA 98004. The listed phone number is (425) 999-2628.
What is Deetta Gray's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Deetta Gray enrolled in Medicare?
Yes. Deetta 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 Deetta Gray's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Deetta Gray reassigns Medicare benefits to Silver Falls Dermatology, LLC (Salem, OR). 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 Deetta Gray's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Deetta Gray accept?
Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Deetta 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 Deetta Gray was last updated on February 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Deetta Gray, M.D., FAAD, FRCPC · NPI 1790825966
Dermatology physician in Bellevue, Washington. Individual provider, active in the CMS NPPES registry since February 7, 2007.
## Identity
- **NPI:** 1790825966 (Entity type: Individual)
- **Enumerated:** February 7, 2007
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **State license:** 025209 MD00035417 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 1515 116TH AVE NE, STE 307, Bellevue, WA 98004-3811
- **Phone:** (425) 999-2628 · **Fax:** (425) 646-2965
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Silver Falls Dermatology, LLC (NPI 1134375421, Salem, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1990
## Record status
- **NPPES last updated:** February 26, 2014
---
Source: [NPI Profile](https://npiprofile.com/npi/1790825966) · Data from the CMS NPPES public registry.