Shantell S Wray, PA is a medicare enrolled "Physician Assistant" in Groveland, Florida. She graduated from nursing school in 2006 and has 19 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Community Health Centers, Inc and her current practice location is
1296 W Broad St, Groveland, Florida. You can reach out to her office (for appointments etc.) via phone at
(407) 905-8827.
Shantell S Wray is licensed to practice in Connecticut (license number 002435) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609966993.
Provider's Profile
| Full Name | Shantell S Wray |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 19 Years |
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| Location | 1296 W Broad St, Groveland, Florida |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Shantell S Wray graduated from nursing school in 2006
NPI Data:
- NPI Number: 1609966993
- Provider Enumeration Date: 10/15/2006
- Last Update Date: 10/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 2062413875
- Enrollment ID: I20170705003310
Medical Identifiers
Medical identifiers for Shantell S Wray such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609966993 | NPI | - | NPPES |
| 1071883 | Other | | NCCPA |
| 115500100 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 002435 (Connecticut) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Community Health Centers, Inc | 4082515390 | 43 |
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. Shantell S 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 |
|---|
Shantell S Wray, PA
110 S Woodland St,
Winter Garden, FL 34787-3546
Ph: (407) 905-8827 | Shantell S Wray, PA
1296 W Broad St,
Groveland, FL 34736-2012
Ph: (407) 905-8827 |
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