KATLIN ALICIA GRAY (PA) – Physician Assistant, NPI 1215636949

KATLIN ALICIA GRAY (PA) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 2023032172 (MO). The NPI Number for KATLIN ALICIA GRAY (PA) is 1215636949

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
KATLIN ALICIA GRAY (PA)
NPI
1215636949
Phone
(314) 251-6440
Address
621 S NEW BALLAS RD STE 560A
Enumeration Date
2 March 2023
Last Update Date
16 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3145696440
Graduation Year
2023 (3 years ago)
PAC ID
3173985272
Group Practice PAC ID
1658320700
Professional Enrollment ID
I20230821002400
Address ID
MO631418261SA621XXRDXX507
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

1,853 PHYSICIAN ASSISTANT in MO

Provider Addresses for KATLIN ALICIA GRAY (PA)

  • 621 S NEW BALLAS RD STE 560A

    SAINT LOUIS, MO 631418261

    Phone: (314) 251-6440

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $35.

Total Amount is formed as General ($35) + Research ($0) + Ownership ($0) = $35.

Last reported payment date: 2024-10-24 • Largest payer in this snapshot: Integra LifeSciences Corporation ($20).

Total Amount

$35

General + Research + Ownership

Payments

2

Total payment records

General Amount

$35

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-24

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: 2023-08-21

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
I20230821002400IPhysician AssistantMOTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63141)

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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: 1658320700View full group profile
NameSpecialtyState
Nurse PractitionerMO
Physician AssistantMO
Nurse PractitionerMO
Nurse PractitionerMO
-MO
Physician AssistantMO
Physician AssistantMO
Nurse PractitionerMO
Physician AssistantIL
General SurgeryIL

Reviews

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Frequently asked questions

How do payers reference KATLIN ALICIA GRAY (PA)?
For KATLIN ALICIA GRAY (PA), use NPI 1215636949 as the unique 10-digit identifier.
Is there an active status for KATLIN ALICIA GRAY (PA)?
For scheduling context, KATLIN ALICIA GRAY (PA) is shown as active in the registry.
How would a patient describe KATLIN ALICIA GRAY (PA)'s focus?
For KATLIN ALICIA GRAY (PA), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Where in Missouri is KATLIN ALICIA GRAY (PA) registered?
Use Saint Louis, Missouri as the headline location for KATLIN ALICIA GRAY (PA) here.
Does KATLIN ALICIA GRAY (PA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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