Individual provider Active NPI

Tracy A Frausto, M.D.

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1164527396
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36504 Issued in AZ
Practice address
7400 S Power Rd
Suite 140
Gilbert, AZ 85297-9281
Phone
(480) 615-2010
Fax
(480) 279-1189
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A88268 CA
Pediatrics Physician 208000000X 36504 AZ Primary

Addresses

Primary practice location

7400 S Power Rd
Suite 140
Gilbert, AZ 85297-9281

Mailing address

PO Box 16455
Mesa, AZ 85211-6455
Phone (480) 615-2010

Other practice location 1

483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Phone (602) 528-1200

Other identifiers 1

IdentifierTypeStateIssuer
218244MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130321000198 AZ Practitioner - Pediatric Medicine 3375788433 Reassigns benefits to 1 organization
I20231122003182 TX Practitioner - Pediatric Medicine 3375788433 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A88268CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gila River Health Care Corporation CurrentSince Oct 12, 2023 Accepting new patients
Gila River Health Care CurrentSince Oct 12, 2023 Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Jul 5, 2014 Accepting new patients
Gila River Health Care Corporation Current Accepting new patients
Banner Childrens Banner Health Clinic LLC CurrentSince Jul 5, 2014 Accepting new patients

Locations

1075 S Idaho Rd
Ste 206
Apache Junction, AZ 85119
Phone (480) 827-5005

1760 E Florence Blvd
Ste 100
Casa Grande, AZ 85122
Phone (520) 374-6505

1811 E McMurray Blvd
Casa Grande, AZ 85122
Phone (520) 374-2090

7400 S Power Rd
Ste 140
Gilbert, AZ 85297
Phone (480) 590-1442

3921 E Baseline Rd
Ste 102
Gilbert, AZ 85234
Phone (480) 615-2010

3493 S Mercy Rd
Bldg 15
Gilbert, AZ 85297
Phone (480) 827-5042

17487 S Healthcare Dr
#H
Laveen, AZ 85339
Phone (520) 550-6000

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

48203 W Farrell Rd
#H
Maricopa, AZ 85139
Phone (520) 568-3881

1450 S Dobson Rd
Ste B220
Mesa, AZ 85202
Phone (480) 827-5044

8405 E Baseline Rd
Ste 107
Mesa, AZ 85209
Phone (480) 936-7722

2152 S Vineyard
Ste B129
Mesa, AZ 85210
Phone (480) 827-5043

1220 S Higley Rd
Ste 101
Mesa, AZ 85206
Phone (480) 615-2010

117 E Main St
Ste A100
Payson, AZ 85541
Phone (928) 474-1714

13640 N Plaza del Rio Blvd
Peoria, AZ 85381
Phone (623) 876-3800

21772 S Ellsworth Loop Rd
Queen Creek, AZ 85142
Phone (480) 512-3700

14416 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 583-5083

Organizations & group practices 5

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1164527396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16455",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852116455",
            "telephone_number": "480-615-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD",
            "address_2": "SUITE 140",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979281",
            "telephone_number": "480-615-2010",
            "fax_number": "480-279-1189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "483 W Seed Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Sacaton",
            "state": "AZ",
            "postal_code": "851475000",
            "country_code": "US",
            "telephone_number": "602-528-1200",
            "fax_number": "602-528-1255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRAUSTO",
        "first_name": "TRACY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88268",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "36504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218244",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.