NPIMap

Individual provider Active NPI

Jacqueline Tracey

  • Surgery Physician
  • Concord, NC
National Provider Identifier
1013136415
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2015-01537 Issued in NC
Practice address
200 Medical Park Dr
Suite 430
Concord, NC 28025-2982
Phone
(704) 403-7070
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2015-01537 NC Primary

Addresses

Primary practice location

200 Medical Park Dr
Suite 430
Concord, NC 28025-2982

Mailing address

200 Medical Park Drive
Concord, NC 28025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, NY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150919000145 NC Practitioner - General Surgery 7416982798 Reassigns benefits to 3 organizations
I20221229002589 NY Practitioner - General Surgery 7416982798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, San Diego School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

200 Medical Park Dr
Suite 430
Concord, NC 28025-0939
Phone (704) 403-5890

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01537NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Oct 11, 2022 Accepting new patients
Carolinas Medical Center CurrentSince Jan 15, 2018 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Aug 1, 2020 Accepting new patients
Health Quest Medical Practice, PC CurrentSince Oct 11, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Mission Hospitals Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Surgery CurrentSince Aug 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Jan 15, 2018 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince Jan 15, 2018 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 15, 2018 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients
Central California Inpatient Physicians Surgery Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

200 Medical Park Dr
Ste 430
Concord, NC 28025
Phone (704) 403-5890

200 Medical Park Dr
Concord, NC 28025
Phone (704) 403-2777

441 McAlister Rd
Lincolnton, NC 28092
Phone (980) 212-4000

441 McAlister Rd
Ste 2100
Lincolnton, NC 28092
Phone (980) 212-6250

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: jtracey97614@capefearvalley.direct-ci.com
  • Direct secure messaging: jtracey499656@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 8

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1013136415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DRIVE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK DR",
            "address_2": "SUITE 430",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252982",
            "telephone_number": "704-403-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2015-01537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.