Individual provider Active NPI

Robert N Tracy, M.D.

  • Family Medicine Physician
  • Edgewood, KY
National Provider Identifier
1003848763
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26618 Issued in KY
Practice address
413 South Loop Road
Edgewood, KY 41017-5446
Phone
(859) 301-3800
Fax
(859) 301-3987
NPI assigned
Jul 6, 2006
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26618 KY Primary

Addresses

Primary practice location

413 South Loop Road
Edgewood, KY 41017-5446

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 781-4111

Other practice location 1

2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 781-4111

Other identifiers 4

IdentifierTypeStateIssuer
64266182MedicaidKY
0101286MedicaidOH
P00839856OtherKYRAILROAD MEDICARE
080092534OtherKYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100116000156 KY Practitioner - Family Practice 0345382164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Elizabeth Medical Center, IncGroup PAC ID 0648174623, 187 clinicians

Practice addresses (Care Compare)

413 S Loop Rd
Edgewood, KY 41017-5446
Phone (859) 301-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26618KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Dec 20, 2022 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Jul 1, 2020 Accepting new patients
St. Elizabeth Medical Center, Inc. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Summit Medical Group, Inc Family Medicine Current Accepting new patients
Summit Medical Group, Inc. Family Medicine CurrentSince Dec 20, 2022 Accepting new patients
St Elizabeth Medical Center, Inc Family Medicine Current Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients
Baptist Convalescent Center, Inc. Past Accepting new patients
Cincinnati Health Care Group PSC Past Accepting new patients

Locations

125 Saint Michael Dr
Cold Spring, KY 41076
Phone (859) 441-3120

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610

413 S Loop Rd
Edgewood, KY 41017
Phone (859) 301-3800

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

2626 Alexandria Pike
Highland Heights, KY 41076
Phone (859) 757-0434

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: rtracy5837@direct-prd.stelizabeth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1003848763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-781-4111",
            "fax_number": "859-441-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 SOUTH LOOP ROAD",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410175446",
            "telephone_number": "859-301-3800",
            "fax_number": "859-301-3987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2626 Alexandria Pike",
            "address_purpose": "LOCATION",
            "city": "Highland Heights",
            "state": "KY",
            "postal_code": "410761530",
            "country_code": "US",
            "telephone_number": "859-781-4111",
            "fax_number": "859-441-5214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "ROBERT",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "26618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64266182",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101286",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00839856",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080092534",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.