Individual provider Active NPI

Tracy Lynn Prizant, MD

  • Dermatology Physician
  • Pittsburgh, PA
National Provider Identifier
1104827161
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD057723L Issued in PA
Practice address
5770 Baum Blvd
Ste 200
Pittsburgh, PA 15206-3763
Phone
(412) 661-5500
Fax
(412) 661-4365
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD057723L PA Primary

Addresses

Primary practice location

5770 Baum Blvd
Ste 200
Pittsburgh, PA 15206-3763

Mailing address

5770 Baum Blvd
Ste 200
Pittsburgh, PA 15206-3763
Phone (412) 661-5500

Other identifiers 2

IdentifierTypeStateIssuer
834323OtherPAHIGHMARK BLUE CROSS/BLUE
0015942410001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000356 PA Practitioner - Dermatology 7517042005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Pittsburgh School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greater Pittsburgh Orthopaedic Associates IncGroup PAC ID 0446157556, 40 clinicians

Practice addresses (Care Compare)

5820 Centre Ave
Pittsburgh, PA 15206-3710
Phone (412) 661-5500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions79
Removal or shaving of skin growth60
Skin biopsy57

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Pittsburgh Orthopaedic Associates Inc CurrentSince Jan 1, 2011 Accepting new patients
Greater Pittsburgh Orthopaedic Associates, Inc. CurrentSince Jan 1, 2011 Accepting new patients
Dermatological Associates PC Dermatology PastSince Nov 5, 2007 Accepting new patients
Advanced Dermatology of Pennsylvania, PC Dermatology PastSince Jul 1, 2016 Accepting new patients

Locations

5770 Baum Blvd
Ste 200
Pittsburgh, PA 15206

5820 Centre Ave
Pittsburgh, PA 15206
Phone (412) 661-6484

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1104827161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 BAUM BLVD",
            "address_2": "STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063763",
            "telephone_number": "412-661-5500",
            "fax_number": "412-661-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 BAUM BLVD",
            "address_2": "STE 200",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063763",
            "telephone_number": "412-661-5500",
            "fax_number": "412-661-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIZANT",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD057723L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS/BLUE",
            "identifier": "834323",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015942410001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.