Dr Adam Wray, DO is a medicare enrolled "Dermatology" physician in Blackfoot, Idaho. He went to At Still University Of Health Sciences, College Of Osteo Med, Kirksville and graduated in 2003 and has 23 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Wray Dermatology and his current practice location is
326 Poplar St Ste 101, Blackfoot, Idaho. You can reach out to his office (for appointments etc.) via phone at
(986) 275-0003.
Dr Adam Wray is licensed to practice in Idaho (license number O-0444) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1902952930.
Physician's Profile
| Full Name | Dr Adam Wray |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 23 Years |
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| Location | 326 Poplar St Ste 101, Blackfoot, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Adam Wray attended and graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2003
NPI Data:
- NPI Number: 1902952930
- Provider Enumeration Date: 01/25/2007
- Last Update Date: 07/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 4385696137
- Enrollment ID: I20071109000278
Medical Identifiers
Medical identifiers for Dr Adam Wray such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1902952930 | NPI | - | NPPES |
| 000010163016 | Other | ID | REGENCE BLUE SHIELD POC |
| S6116 | Other | ID | BLUE CROSS BLKFT |
| S6117 | Other | ID | BLUE CROSS POC |
| 807719000 | Medicaid | ID | |
| 000010163015 | Other | ID | REGENCE BLUE SHIELD BLKFT |
| 315520 | Other | ID | ALTIUS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207N00000X | Dermatology | O-0444 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Wray Dermatology | 8921541277 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Adam Wray allows following entities to bill medicare on his behalf.
| Entity Name | Bmh Inc |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1982805271 PECOS PAC ID: 8426149758 Enrollment ID: O20070801000213 |
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| Entity Name | Bmh Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1255539193 PECOS PAC ID: 8426149758 Enrollment ID: O20071018000897 |
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| Entity Name | Wray Dermatology |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457110298 PECOS PAC ID: 8921541277 Enrollment ID: O20240614003462 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Adam Wray is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Dr Adam Wray, DO 326 Poplar St Ste 101, Blackfoot, ID 83221-1741 Ph: (986) 275-0003 | Dr Adam Wray, DO 326 Poplar St Ste 101, Blackfoot, ID 83221-1741 Ph: (986) 275-0003 |
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