Individual provider Active NPI

Tracy L Maier, D.O.

  • Pediatrics Physician
  • Webster, NY
National Provider Identifier
1003995903
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
239979 Issued in NY
Practice address
505 Willowgate Dr
Webster, NY 14580-8567
Phone
(585) 690-1255
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 239979 NY Primary

Addresses

Primary practice location

505 Willowgate Dr
Webster, NY 14580-8567

Mailing address

505 Willowgate Dr
Webster, NY 14580-8567
Phone (585) 690-1255

Other practice location 1

353 Island Cottage Rd
Rochester, NY 14612-2349
Phone (585) 225-2610

Other practice location 2

77 Sullys Trl
Pittsford, NY 14534-3754
Phone (585) 389-6040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200227000242 NY Practitioner - Pediatric Medicine 4183051402 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital Pediatrics Current Accepting new patients
Western New York Medical Practice P.C. Pediatrics CurrentSince Jan 6, 2020 Accepting new patients
Western New York Medical Practice PC CurrentSince Jan 6, 2020 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jan 6, 2020 Accepting new patients
The Unity Hospital of Rochester CurrentSince Jan 6, 2020 Accepting new patients
Rochester General Hospital CurrentSince Jan 6, 2020 Accepting new patients
Rochester General Hospital CurrentSince Jan 6, 2020 Accepting new patients

Locations

77 Sullys Trl
Pittsford, NY 14534
Phone (585) 248-5300

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

1555 Long Pond Rd
Rochester, NY 14626
Phone (585) 429-2289

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

353 Island Cottage Rd
Rochester, NY 14612
Phone (585) 225-2610

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1003995903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WILLOWGATE DR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145808567",
            "telephone_number": "585-690-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WILLOWGATE DR",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145808567",
            "telephone_number": "585-690-1255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "353 Island Cottage Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146122349",
            "country_code": "US",
            "telephone_number": "585-225-2610",
            "fax_number": "585-581-1396",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "77 Sullys Trl",
            "address_purpose": "LOCATION",
            "city": "Pittsford",
            "state": "NY",
            "postal_code": "145343754",
            "country_code": "US",
            "telephone_number": "585-389-6040",
            "fax_number": "585-248-3427",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAIER",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "239979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, NY

Sources for this page

Verify at the official NPI Registry.