Tracey A. Henderson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

C1-0011343 Issued in DE

Practice address

4755 Ogletown-Stanton Road
Map 1, Suite 116
Newark, DE 19718-2200

Phone

(302) 733-4200

Fax

(302) 733-2711

NPI assigned

Mar 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Tracey Ann Perazone Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracey.henderson@ah.eclinicaldirectplus.com

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.

• Adirondack Medical Center

  • General Practice Physician
  • Saranac Lake, NY
  • NPI 1245446533
  Medicare reassignment NPD
• Adirondack Medical Center

  • Surgery Physician
  • Saranac Lake, NY
  • NPI 1871359000
  NPD
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1699709576
  NPD (past)

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1013188754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HYGEIA DRIVE, SUITE 2300",
            "address_2": "CCHS PHYSICIAN CONTRACTING",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197132049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 OGLETOWN-STANTON ROAD",
            "address_2": "MAP 1, SUITE 116",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197182200",
            "telephone_number": "302-733-4200",
            "fax_number": "302-733-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TRACEY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "258019",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DE",
            "license": "C1-0011343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "PERAZONE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Helping & Healing
• Christopher Henderson, PT, DPT
• Chryshele Henderson
• Gloria M Henderson, BS, CADC
• Kristy Henderson, PHARM.D.
• Donna M Hendrie, DO
• Elizabeth C Henninger, DPT
• Connita Henry, LCSW
• Jill Christine Henry
• Todd Douglas Henry Jr.

• Pediatrics Physician in Newark, DE
• Providers in Newark, DE by specialty
• Pediatrics Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.