Kelly Matthew Ray, CRNA - Medicare Nurse Anesthetist, Certified Registered in Jackson, MS

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Kelly Matthew Ray, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jackson, Mississippi. His current practice location is 971 Lakeland Dr, Suite 202, Jackson, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 362-1990.

Kelly Matthew Ray is licensed to practice in Mississippi (license number R885450) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417345836.

Contact Information

Kelly Matthew Ray, CRNA
971 Lakeland Dr, Suite 202,
Jackson, MS 39216-4643
(601) 362-1990
Not Available

Map and Direction




Provider's Profile

Full NameKelly Matthew Ray
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location971 Lakeland Dr, Jackson, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1417345836
  • Provider Enumeration Date: 01/07/2015
  • Last Update Date: 01/07/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 8921324054
  • Enrollment ID: I20150306001463

Medical Identifiers

Medical identifiers for Kelly Matthew Ray such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1417345836NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered R885450 (Mississippi)Primary

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. Kelly Matthew Ray allows following entities to bill medicare on his behalf.
Entity NamePhysicians Anesthesia Group, P.a.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407890783
PECOS PAC ID: 6103806864
Enrollment ID: O20040722001098
Entity NameWillow Anesthesia Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205169521
PECOS PAC ID: 9234279183
Enrollment ID: O20091228000308
Entity NameLifelinc Anesthesia Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801021464
PECOS PAC ID: 0941347447
Enrollment ID: O20130522000277
Entity NameGulf Anesthesia Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548696925
PECOS PAC ID: 8426286501
Enrollment ID: O20140117000585
Entity NameYoungs Professional Services Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922178599
PECOS PAC ID: 2163524992
Enrollment ID: O20141015000028
Entity NameDelta Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447818026
PECOS PAC ID: 9830593821
Enrollment ID: O20210812003936
Entity NameSeahorse Anesthesia
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1588497705
PECOS PAC ID: 0547793770
Enrollment ID: O20241028000605

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. Kelly Matthew Ray 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 AddressPractice Location Address
Kelly Matthew Ray, CRNA
971 Lakeland Dr, Suite 202,
Jackson, MS 39216-4643

Ph: (601) 362-1990		Kelly Matthew Ray, CRNA
971 Lakeland Dr, Suite 202,
Jackson, MS 39216-4643

Ph: (601) 362-1990

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Jackson, MS

Emily Sumrall Childress, CRNA
Nurse Anesthetist - CR
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Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    
Theresa Ann Davis, CRNA
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Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    
Austin Grant Conn, DNP
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Mollie Harrell,
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Practice Location: 2500 N State St, Pfs, Jackson, MS 39216
Phone: 601-984-4619    
John Tyler Mclendon,
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Medicare: Accepting Medicare Assignments
Practice Location: 1850 Chadwick Dr, Jackson, MS 39204
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James Walter Ishee, CRNA
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Medicare: Accepting Medicare Assignments
Practice Location: 2500 N State St, Jackson, MS 39216
Phone: 601-984-1000    
Zachary Halliwell, CRNA
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Medicare: Accepting Medicare Assignments
Practice Location: 969 Lakeland Dr, Jackson, MS 39216
Phone: 601-200-2000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.