Jacquis Leshay Gray, PA-C is a medicare enrolled "Physician Assistant" in Lathrup Village, Michigan. Her current practice location is
26333 Southfield Rd, Lathrup Village, Michigan. You can reach out to her office (for appointments etc.) via phone at
(248) 331-1900.
Jacquis Leshay Gray is licensed to practice in Michigan (license number 5601008149) 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 1457883274.
Provider's Profile
Full Name | Jacquis Leshay Gray |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 26333 Southfield Rd, Lathrup Village, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457883274
- Provider Enumeration Date: 03/30/2017
- Last Update Date: 12/05/2017
Medicare PECOS Information:
- PECOS PAC ID: 9739450412
- Enrollment ID: I20170731001962
Medical Identifiers
Medical identifiers for Jacquis Leshay Gray such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457883274 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 5601008149 (Michigan) | Primary |
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. Jacquis Leshay 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 |
Jacquis Leshay Gray, PA-C 26333 Southfield Rd, Lathrup Village, MI 48076-4574 Ph: () - | Jacquis Leshay Gray, PA-C 26333 Southfield Rd, Lathrup Village, MI 48076-4574 Ph: (248) 331-1900 |
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