MRS. AMY GOODFELLOW WRAY (PA-C) – Physician Assistant, NPI 1396762076
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for MRS. AMY GOODFELLOW WRAY (PA-C)
Sharp Grossmont Hospital, 5555, Grossmont Center Drive, La Mesa, San Diego County, California, 91942, United States
LA MESA, CA 919423019
Phone: (619) 644-3030
Fax: (619) 644-3638
Type: Mailing
5555 Grossmont Center Dr
LA Mesa, CA 919423019
Phone: (619) 644-3030
Fax: (619) 644-3638
Type: Location
1505 Encinitas Blvd
Encinitas, CA 920242933
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
1200 Garden View Rd
Encinitas, CA 920242477
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
4250 1st Ave
San Diego, CA 92103
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
3855 Health Sciences Dr
LA Jolla, CA 920933019
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
16950 Via Tazon
San Diego, CA 921271607
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
910 Sycamore Ave Ste 270
Vista, CA 920817852
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
9400 Campus Point Dr
LA Jolla, CA 920933019
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
FILE 57326
LOS ANGELES, CA 900747326
Phone: (800) 926-8273
Type: Mailing
200 W ARBOR DR
SAN DIEGO, CA 921039000
Phone: (800) 926-8273
Fax: (888) 539-8781
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $59.
Total Amount is formed as General ($59) + Research ($0) + Ownership ($0) = $59.
Last reported payment date: 2024-09-06 • Largest payer in this snapshot: Shockwave Medical, Inc ($27).
Total Amount
$59
General + Research + Ownership
Payments
3
Total payment records
General Amount
$59
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Shockwave Medical, Inc | $27 |
| Abbott Laboratories | $16 |
| ABBVIE INC. | $15 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-01-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070117000440 | I | Physician Assistant | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 91942)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | CA | |
| - | CA | |
| - | CA | |
| Surgical Oncology, General Surgery | MI | |
| - | CA | |
| - | CA | |
| - | CA | |
| Physician Assistant | CA | |
| - | CA | |
| Emergency Medicine, Medical Toxicology | CA |
Reviews
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