DR. BENNETT G IV GRAY (MD) – Diagnostic Radiology Physician, NPI 1376637132
Diagnostic Radiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. BENNETT G IV GRAY (MD)
77 E Southcrest Cir
Edwardsville, IL 620253147
Phone: (618) 659-0457
Type: Location
310 W Losey St
Scott AFB, IL 622255250
Phone: (618) 256-7411
Type: Location
77, East Southcrest Circle, Edwardsville, Madison County, Illinois, 62025, United States
EDWARDSVILLE, IL 620253147
Phone: (618) 659-0457
Type: Location
9821 IRVINE CENTER DR
IRVINE, CA 926184307
Phone: (800) 741-7629
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $2,116.
Total Amount is formed as General ($2,116) + Research ($0) + Ownership ($0) = $2,116.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Abbott Laboratories ($2,116).
Total Amount
$2,116
General + Research + Ownership
Payments
9
Total payment records
General Amount
$2,116
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $2,116 |
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: 2024-07-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20080218000217 | I | Diagnostic Radiology | IL | TBD |
| I20240727000201 | I | Diagnostic Radiology | MD | TBD |
| I20240727000266 | I | Diagnostic Radiology | DC | 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 62025)
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Reviews
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