Tiffany Monique Gray, in Baltimore, MD - Medicare Nurse Practitioner

Tiffany Monique Gray, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Baltimore, Maryland. Her current practice location is 4320 Glenmore Ave, Baltimore, Maryland. You can reach out to her office (for appointments etc.) via phone at (443) 570-5072.

Tiffany Monique Gray is licensed to practice in Maryland (license number R149695) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053120014.

Contact Information

	Tiffany Monique Gray,
	4320 Glenmore Ave, Baltimore, MD 21206-1919
	(443) 570-5072
	Not Available

Map and Direction

Provider's Profile

Full Name	Tiffany Monique Gray
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	4320 Glenmore Ave, Baltimore, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053120014
Provider Enumeration Date: 01/04/2025
Last Update Date: 01/04/2025

Medicare PECOS Information:

PECOS PAC ID: 9234652272
Enrollment ID: I20250331001408

Medical Identifiers

Medical identifiers for Tiffany Monique Gray such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053120014	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	R149695 (Maryland)	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. Tiffany Monique Gray allows following entities to bill medicare on her behalf.

Entity Name	Toller Enterprises, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821697533 PECOS PAC ID: 8628481926 Enrollment ID: O20210105002952

Entity Name	Spiritual Healing
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003502337 PECOS PAC ID: 7113388802 Enrollment ID: O20230727002041

Entity Name	Integrahealth Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740049568 PECOS PAC ID: 3678911625 Enrollment ID: O20240410000064

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. Tiffany Monique Gray 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
Tiffany Monique Gray, 4320 Glenmore Ave, Baltimore, MD 21206-1919 Ph: (443) 570-5072	Tiffany Monique Gray, 4320 Glenmore Ave, Baltimore, MD 21206-1919 Ph: (443) 570-5072

Reviews and Comments

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Tiffany Monique Gray, - Medicare Nurse Practitioner in Baltimore, MD