Tracy Colangelo

Primary specialty

ContractorTaxonomy code 171W00000X

License

281474091 Issued in NY

Practice address

689 Nicolls Rd
Deer Park, NY 11729-2725

Phone

(631) 300-6153

NPI assigned

Jan 26, 2009

Last updated

Dec 6, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Not Just Kids Inc

  • Early Intervention Provider Agency
  • Deer Park, NY
  • NPI 1013557065
  NPD Authorized official

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1083852214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 NICOLLS RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292725",
            "telephone_number": "631-300-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 NICOLLS RD",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117292725",
            "telephone_number": "631-300-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "281474091",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl A. Christie, PT, AT,C, CSCS
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• Clickstaff
• Makeetah Cochy
• Comfort Your Sole, Inc
• Commack Care Pharmacy Corp
• Community Chiropractic Care, PC
• Community Surgical Supply of Toms River, Inc
• Comprehensive Medical PC

• Contractor in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Contractor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.