Individual provider Active NPI

Tracey Nicole Waite, LCSW

  • Clinical Social Worker
  • Arcadia, FL
National Provider Identifier
1053507020
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8162 Issued in FL
Practice address
725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752
Phone
(863) 494-1242
NPI assigned
Sep 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 8162 FL Primary

Addresses

Primary practice location

725 N 12TH Ave BLDG B
Arcadia, FL 34266-8752

Mailing address

1355 S International Pkwy
Ste 1481
Lake Mary, FL 32746-1694
Phone (407) 559-7011

Other identifiers 1

IdentifierTypeStateIssuer
SW 8162OtherFLLCSW

Other names 1

  • Mrs. Nicole Waite Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111012000670 FL Practitioner - Clinical Social Worker 1557533767 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 18, 2024 Accepting new patients
MCR Health, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
MCR Health, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 8th Ave W
Ste 101
Palmetto, FL 34221
Phone (941) 776-4008

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15671/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1053507020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 S INTERNATIONAL PKWY",
            "address_2": "STE 1481",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461694",
            "telephone_number": "407-559-7011",
            "fax_number": "407-559-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 N 12TH AVE BLDG B",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668752",
            "telephone_number": "863-494-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "TRACEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-24",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW 8162",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "WAITE",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Arcadia, FL

Sources for this page

Verify at the official NPI Registry.