Individual provider Active NPI

Tracey Crossman, PA

  • Physical Medicine & Rehabilitation Physician
  • Wellesley, MA
National Provider Identifier
1154890002
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PA2461 Issued in MA
Practice address
378 Washington St
Wellesley, MA 02481-6207
Phone
(781) 489-5541
Fax
(781) 489-5340
NPI assigned
Nov 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X PA2461 MA Primary

Addresses

Primary practice location

378 Washington St
Wellesley, MA 02481-6207

Mailing address

378 Washington St
Wellesley, MA 02481-6207
Phone (781) 489-5541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190129001766 MA Practitioner - Physician Assistant 7517204571 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: crossman.tracey.nwins@direct.partners.masshiway.net

Organizations & group practices 1

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1154890002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816207",
            "telephone_number": "781-489-5541",
            "fax_number": "781-489-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816207",
            "telephone_number": "781-489-5541",
            "fax_number": "781-489-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSMAN",
        "first_name": "TRACEY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "PA2461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.