Tracy Lyn Farrey, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4900 Issued in OR

Practice address

1271 N 6TH St
Milwaukee, WI 53212-3360

Phone

(414) 978-9100

NPI assigned

Nov 23, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tracey Petri Former name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1700862000
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1104809052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11481 SW HALL BLVD",
            "address_2": "STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238403",
            "telephone_number": "800-219-8835",
            "fax_number": "503-443-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 N 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123360",
            "telephone_number": "414-978-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58147 Columbia River Hwy",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "St Helens",
            "state": "OR",
            "postal_code": "970516229",
            "country_code": "US",
            "telephone_number": "503-397-1914",
            "fax_number": "503-366-0422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARREY",
        "first_name": "TRACY",
        "middle_name": "LYN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269616",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "PETRI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amin Farokhrani
• Junaid M Farooq, M.D.
• Mustafa Farooque, MD
• Christine Ellen Farrell
• Kathy Lynn Farrell, LPC
• Charonda Patrice Farrington, R.N.
• Lynn Ann Farrow, O.T.
• Elizabeth Grace Farvour
• Farzad Kamrani,MD.SC.
• Patricia F Fasciotti, PT

• Physical Therapist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.