SAMANTHA M GRAY (FNP-C) – Family Nurse Practitioner, NPI 1124370010

SAMANTHA M GRAY (FNP-C) is a healthcare provider. based in Newark, Delaware. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. LG-0000634 (DE). The NPI Number for SAMANTHA M GRAY (FNP-C) is 1124370010

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
SAMANTHA M GRAY (FNP-C)
NPI
1124370010
Phone
(302) 738-5500
Address
86 Omega Dr Ste 86
Enumeration Date
3 October 2012
Last Update Date
16 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3028364200
Graduation Year
2012 (14 years ago)
PAC ID
2264683440
Group Practice PAC ID
6901870948
Professional Enrollment ID
I20121116000150
Address ID
DE197024777NE2600XAVEX306
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Digital endpointsOther names

1,273 NURSE PRACTITIONER in DE

Provider Addresses for SAMANTHA M GRAY (FNP-C)

  • 86 Omega Dr Ste 86

    Newark, DE 197132065

    Phone: (302) 738-5500

    Fax: (302) 738-9449

    Type: Location

  • 405 Silverside Rd Ste 111

    Wilmington, DE 198091768

    Phone: (302) 798-0666

    Fax: (302) 798-2401

    Type: Location

  • 405 SILVERSIDE RD

    SUITE 111

    WILMINGTON, DE 198091774

    Phone: (302) 798-0666

    Fax: (302) 798-2401

    Type: Mailing

  • 2600 GLASGOW AVE

    SUITE 124

    NEWARK, DE 197024773

    Phone: (302) 836-4200

    Fax: (302) 836-8431

    Type: Location

  • 405 SILVERSIDE RD STE 111

    WILMINGTON, DE 198091768

    Phone: (302) 798-0666

    Fax: (302) 798-2401

    Type: Mailing

  • 2600 GLASGOW AVE STE 124

    NEWARK, DE 197024777

    Phone: (302) 836-4200

    Fax: (302) 836-8431

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 195 Open Payments records for all available years, with a total value of $3,852.

Total Amount is formed as General ($3,852) + Research ($0) + Ownership ($0) = $3,852.

Last reported payment date: 2024-12-31 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($535).

Total Amount

$3,852

General + Research + Ownership

Payments

195

Total payment records

General Amount

$3,852

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-31

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2012-11-16

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20121116000150INurse PractitionerDETBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes640315$0
G0438Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit160160$0
96127Assessment of emotional or behavioral problems125120$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit9494$0
G0008Administration of influenza virus vaccine7473$0
View full utilization report →

Insurance plans in this area (ZIP 19713)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901870948View full group profile
NameSpecialtyState
Family PracticeDE
-DE
Internal MedicineDE
Family PracticeDE
Nurse PractitionerDE
Nurse PractitionerDE
Nurse PractitionerDE
Internal MedicineDE
Internal MedicineDE

Reviews

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Frequently asked questions

What is the standard ID for SAMANTHA M GRAY (FNP-C) in the U.S.?
In the U.S., SAMANTHA M GRAY (FNP-C) is identified by NPI 1124370010.
Should I treat SAMANTHA M GRAY (FNP-C) as an active provider?
Patients and plans typically see SAMANTHA M GRAY (FNP-C) as active in the national extract.
How should patients interpret SAMANTHA M GRAY (FNP-C)'s specialty?
The extract shows Family Nurse Practitioner for SAMANTHA M GRAY (FNP-C). Clinical services aligned with this taxonomy classification.
What geographic area is tied to SAMANTHA M GRAY (FNP-C)?
SAMANTHA M GRAY (FNP-C) is associated with Newark, Delaware in the same public data insurers reference.
Who maintains SAMANTHA M GRAY (FNP-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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