SHANTELL S WRAY (PA) – Physician Assistant, NPI 1609966993

SHANTELL S WRAY (PA) is a healthcare provider. based in Winter garden, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 002435 (CT). The NPI Number for SHANTELL S WRAY (PA) is 1609966993

Main info

Female
20 Years Of Experience
Accepts Medicare Assignment
Name
SHANTELL S WRAY (PA)
NPI
1609966993
Phone
(407) 905-8827
Address
110 S WOODLAND ST
Enumeration Date
15 October 2006
Last Update Date
3 October 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4079058827
Graduation Year
2006 (20 years ago)
PAC ID
2062413875
Group Practice PAC ID
4082515390
Professional Enrollment ID
I20170705003310
Address ID
FL347485150LE225XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for SHANTELL S WRAY (PA)

  • 110 S WOODLAND ST

    WINTER GARDEN, FL 347873546

    Phone: (407) 905-8827

    Fax: (407) 905-8998

    Type: Mailing

  • 1296 W BROAD ST

    GROVELAND, FL 347362012

    Phone: (407) 905-8827

    Fax: (352) 429-5606

    Type: Location

  • 350, Main Avenue, Winnipauk, Norwalk, Fairfield County, Connecticut, 06851, United States

    C/O DR. APPLEBY SCHOOL BASED HEALTH CENTER AT BRIGGS HS

    NORWALK, CT 068511510

    Phone: (203) 846-6385

    Fax: (203) 846-6395

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2017-07-05

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
I20170705003310IPhysician AssistantFLTBD

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
36415Insertion of needle into vein for collection of blood sample9048$0
View full utilization report →

Insurance plans in this area (ZIP 34787)

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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: 4082515390View full group profile
NameSpecialtyState
Nurse PractitionerNY
O B S T E T R I C S/ G Y N E C O L O G YFL
Physician AssistantFL
-FL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
-FL
Family PracticeFL
Family PracticeFL

Reviews

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Frequently asked questions

Is there an official ID for SHANTELL S WRAY (PA) in U.S. healthcare records?
The official identifier for SHANTELL S WRAY (PA) is NPI 1609966993.
Is SHANTELL S WRAY (PA) still an active registrant?
SHANTELL S WRAY (PA) carries an active NPI according to the public dataset.
What kind of doctor is SHANTELL S WRAY (PA)?
SHANTELL S WRAY (PA) is associated with Physician Assistant in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for SHANTELL S WRAY (PA)?
Travel planning: use Winter Garden, Florida as the reference point for SHANTELL S WRAY (PA), then confirm.
Can I trust this NPI listing for SHANTELL S WRAY (PA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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