Individual provider Active NPI

Tracy Lawrence-Black, MD

  • Neonatal-Perinatal Medicine Physician
  • Valhalla, NY
National Provider Identifier
1033119953
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
281882 Issued in NY
Practice address
95 Bradhurst Ave
Valhalla, NY 10595-1637
Phone
(914) 592-7555
Fax
(866) 310-5326
NPI assigned
Jul 22, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 33644 DC
Neonatal-Perinatal Medicine Physician 2080N0001X 053808 CT
Neonatal-Perinatal Medicine Physician 2080N0001X 281882 NY Primary

Addresses

Primary practice location

95 Bradhurst Ave
Valhalla, NY 10595-1637

Mailing address

53 Stonewall Cir
West Harrison, NY 10604-1126
Phone (240) 205-0861

Other practice location 1

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050927000195 DC Practitioner - Pediatric Medicine 4789618935 Reassigns benefits to 2 organizations
I20210322000110 NY Practitioner - Pediatric Medicine 4789618935 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
053808CTMDNeonatal-Perinatal Medicine Physician
33644DCMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Montefiore New Rochelle Hospital CurrentSince Feb 12, 2021 Accepting new patients
MGMC LLC CurrentSince Aug 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2022 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
MGMC, LLC Current Accepting new patients
Blythedale Children's Hospital Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

5255 Loughboro Rd NW
Washington, DC 20016
Phone (202) 243-2280

16 Guion Pl
New Rochelle, NY 10801
Phone (914) 365-3680

Interoperability endpoints

  • Direct secure messaging: tlawrenceblack969570@direct.hopkinsmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1033119953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 STONEWALL CIR",
            "city": "WEST HARRISON",
            "state": "NY",
            "postal_code": "106041126",
            "telephone_number": "240-205-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BRADHURST AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951637",
            "telephone_number": "914-592-7555",
            "fax_number": "866-310-5326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Rd NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200072113",
            "country_code": "US",
            "telephone_number": "202-444-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE-BLACK",
        "first_name": "TRACY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "DC",
            "license": "33644",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CT",
            "license": "053808",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "281882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.