Tracey H Fan, D.O

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

287765 Issued in MA

Practice address

55 Fruit St # 721J
Boston, MA 02114-2696

Phone

(617) 726-2000

NPI assigned

Apr 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IN, CO3 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 3

Specialty

Neurology

Education

Touro Un Col of Osteopathic Medicine, Henderson, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Blue Sky Telehealth LLCGroup PAC ID 5395155964, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088
• St David'S South Austin Medical Center Hospital, Austin, TX, CCN 450713
• University of Iowa Health Care Medical Center Down Hospital, Iowa City, IA, CCN 160029
• Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tfan276630@uchospital.direct-ci.com

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.

• Blue Sky Telehealth, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Greenwood Village, CO
  • NPI 1649886458
  Medicare reassignment Care Compare group NPD
• Riverside Health System

  • General Practice Physician
  • Kankakee, IL
  • NPI 1417061193
  Medicare reassignment Care Compare group NPD
• State University of Iowa

  • Family Medicine Physician
  • Iowa City, IA
  • NPI 1477554814

  IL

  Medicare reassignment Care Compare group NPD
• University of Chicago

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1821048786

  IN

  Medicare reassignment Care Compare group NPD
• Southeast Iowa Regional Medical Center, Inc.

  • General Practice Physician
  • West Burlington, IA
  • NPI 1164433884

  IL

  Medicare reassignment NPD
• The Methodist Hospitals, Inc

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  Medicare reassignment NPD
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• Riverside Health System

  • Psychiatry Physician
  • Kankakee, IL
  • NPI 1336354430
  NPD
• The Methodist Hospitals, Inc

  • Neurology Physician
  • Gary, IN
  • NPI 1720290588
  NPD
• The University of Chicago Medical Center

  • Community/Retail Pharmacy
  • Calumet City, IL
  • NPI 1255895678
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Davids Healthcare Partnership LP LLP

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1649223645
  Care Compare affiliation
• St. David'S Healthcare Partnership, L.P., LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1679528889
  Care Compare affiliation
• State University of Iowa

  • General Acute Care Hospital
  • Iowa City, IA
  • NPI 1699541870
  Care Compare affiliation
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1508956509
  Care Compare affiliation

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1174055784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ENGLEWOOD AVE APT 104",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024452072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST # 721J",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-726-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Market St",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522452633",
            "country_code": "US",
            "telephone_number": "319-339-3551",
            "fax_number": "319-887-2847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "228 Saint Charles Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174024661",
            "country_code": "US",
            "telephone_number": "717-851-5503",
            "fax_number": "717-851-5507",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441950001",
            "country_code": "US",
            "telephone_number": "216-444-2200",
            "fax_number": "216-445-9908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "TRACEY",
        "middle_name": "H",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-02",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IA",
            "license": "DO-06915",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "OS024561C",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "287765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "SA6390894",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfan@mgh.harvard.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "55 Fruit St # 721J",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021142696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Familyaid Boston
• Katie R Famous, MD, PHD
• Caleb Kangheng Fan
• Janet Li Fan
• Ming-Hui Fan, MD
• Uniber Fan
• Wei Fan
• Wuqiang Fan, M.D.
• Manuel Fanarjian, M.D.
• Fancy Eyes LLC

• Neurology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Neurology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.