Individual provider Active NPI

Tracey C. Miers, LCSW-R

  • Clinical Social Worker
  • Hamburg, NY
National Provider Identifier
1144286071
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0000038174 Issued in NY
Practice address
40 Main St
Hamburg, NY 14075-4948
Phone
(716) 648-6515
Fax
(716) 648-7101
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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 0000038174 NY Primary

Addresses

Primary practice location

40 Main St
Hamburg, NY 14075-4948

Mailing address

741 Delaware Ave
Buffalo, NY 14209-2201
Phone (716) 218-1450

Other identifiers 5

IdentifierTypeStateIssuer
00030241501OtherNYUNIVERA
040426031053OtherNYFIDELIS
6211350OtherNYINDEPENDENT HEALTH
160743251-58OtherNYPRISM
000523549003OtherNYBLUECROSS/BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000038174NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1144286071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 DELAWARE AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092201",
            "telephone_number": "716-218-1450",
            "fax_number": "716-332-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MAIN ST",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754948",
            "telephone_number": "716-648-6515",
            "fax_number": "716-648-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERS",
        "first_name": "TRACEY",
        "middle_name": "C.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0000038174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00030241501",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "040426031053",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "6211350",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRISM",
            "identifier": "160743251-58",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "000523549003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.