Individual provider Active NPI

Maurie Dolores Tracy, ANP-BC

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1053630103
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2010012804 Issued in MO
Practice address
10426 Baur Blvd
Saint Louis, MO 63132-1905
Phone
(314) 925-0903
Fax
(314) 764-2279
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2010012804 MO Primary

Addresses

Primary practice location

10426 Baur Blvd
Saint Louis, MO 63132-1905

Mailing address

10426 Baur Blvd
Saint Louis, MO 63132-1905
Phone (314) 925-0903

Other practice location 1

15201 Olive Blvd
Chesterfield, MO 63017-1810
Phone (314) 925-0903

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000580 MO Practitioner - Nurse Practitioner 5496995417 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pai Participant 1 LLCGroup PAC ID 8123351954, 174 clinicians
Generation Clinical Partners LLCGroup PAC ID 1557687803, 24 clinicians

Practice addresses (Care Compare)

1020 Woods Mill Rd
Town and Country, MO 63017-0603
Phone (636) 251-4944

15201 Olive Blvd
Chesterfield, MO 63017-1810
Phone (314) 925-0903

15250 Village View Dr
Chesterfield, MO 63017-1982
Phone (636) 733-0199

505 Couch Ave
Kirkwood, MO 63122-5577
Phone (314) 822-9911

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Feb 6, 2026 Accepting new patients
Generation Clinical Partners LLC CurrentSince Mar 1, 2026 Accepting new patients
Generation Clinical Partners LLC CurrentSince Mar 1, 2026 Accepting new patients
Signify Health, LLC CurrentSince Jun 7, 2023 Accepting new patients
American Multispecialty Group Inc. Adult Health CurrentSince Feb 9, 2026 Accepting new patients
Faris Al-Gebory MD LLC PastSince Apr 6, 2018 Accepting new patients

Locations

15201 Olive Blvd
Chesterfield, MO 63017
Phone (636) 532-1515

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

1475 Kisker Rd
Ste 230
Saint Charles, MO 63304
Phone (636) 939-5000

10426 Baur Blvd
Saint Louis, MO 63132
Phone (314) 632-6265

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: maurie.tracy.p1@direct.empowerme.nextgenshare.com
  • FHIR API: https://api.platform.athenahealth.com/9850/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1053630103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10426 BAUR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631321905",
            "telephone_number": "314-925-0903",
            "fax_number": "314-764-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10426 BAUR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631321905",
            "telephone_number": "314-925-0903",
            "fax_number": "314-764-2279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15201 Olive Blvd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630171810",
            "country_code": "US",
            "telephone_number": "314-925-0903",
            "fax_number": "314-764-2279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "MAURIE",
        "middle_name": "DOLORES",
        "name_prefix": "Ms.",
        "credential": "ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2010012804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.