DR. ADAM WRAY (DO) – Dermatology Physician, NPI 1902952930
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
61 DERMATOLOGY in ID
Provider Addresses for DR. ADAM WRAY (DO)
326 POPLAR ST STE 101
BLACKFOOT, ID 832211741
Phone: (986) 275-0003
Fax: (986) 275-0005
Type: Location
Bingham Memorial Hospital, 98, Poplar Street, Blackfoot, Bingham County, Idaho, 83221, United States
BLACKFOOT, ID 832211758
Phone: (208) 785-4100
Type: Mailing
326, Poplar Street, Blackfoot, Bingham County, Idaho, 83221, United States
BLACKFOOT, ID 832211741
Phone: (208) 785-5801
Type: Location
1355 PARKWAY DR STE A
BLACKFOOT, ID 832211656
Phone: (986) 275-0003
Fax: (986) 275-0005
Type: Mailing
500 S 11th Ave Ste 301
Pocatello, ID 832014879
Phone: (986) 275-0003
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $660.
Total Amount is formed as General ($660) + Research ($0) + Ownership ($0) = $660.
Last reported payment date: 2024-11-19 • Largest payer in this snapshot: ABBVIE INC. ($235).
Total Amount
$660
General + Research + Ownership
Payments
26
Total payment records
General Amount
$660
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $235 |
| Kerecis Limited | $187 |
| Axonics, Inc. | $109 |
| LEO Pharma Inc. | $24 |
| Novartis Pharmaceuticals Corporation | $19 |
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: 2017-11-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20071109000278 | I | Dermatology | ID | TBD |
| I20171121000479 | I | Dermatology | AZ | 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 83221)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | OR |
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