Tracy Douglas Murphy, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Quincy, IL
NPI 1174869952 · NPPES record last updated Feb 2, 2023
Key facts
- NPI
- 1174869952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 40263 (SC)
- Practice address
- 1005 Broadway St
Quincy, IL 62301-2834 - Phone
- (217) 222-0954
- NPI assigned
- Dec 23, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Pathology
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Central Pathology Specialists SC
Practice addresses (Care Compare)
1005 Broadway St
Quincy, IL 62301-2834
Phone 21722384006209
Hospital & facility affiliations
- Blessing Hospital
- Illini Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201224000164 | IL | Practitioner - Pathology | 0244642809 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.097469 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
| 40263 | SC | MD | Anatomic Pathology & Clinical Pathology Physician |
| 7152A | WY | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Central Pathology Specialists, S.C. | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
| Blessing Hospital | Current |
Accepting new patients | |
| Blessing Hospital | Current | Accepting new patients | |
| Blessing Hospital | Current |
Accepting new patients | |
| Quincy Clinical Laboratory Services SC | Anatomic Pathology & Clinical Pathology | Current |
Accepting new patients |
| Blessing Hospital | Past | Accepting new patients |
Locations
4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444
1005 Broadway St
Quincy, IL 62301
100 Medical Dr
Hannibal, MO 63401
101 Medical Dr
Hannibal, MO 63401
103 E Commercial St
Kahoka, MO 63445
Phone (660) 727-3377
5700 Southwyck Blvd
Toledo, OH 43614
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036.097469 | IL | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 2022002918 | MO | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 7152A | WY | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 40263 | SC | Yes |
Addresses
Primary practice location
1005 Broadway St
Quincy, IL 62301-2834
Mailing address
4619 Trinity Lakes Dr
Quincy, IL 62305-4404
Phone (307) 365-2192
Other providers in Quincy, IL
- Mark R Mount
- Heidi Muegge
- Merle Henry Muller
- Maha Mumtaz
- Lori Ann Murphy
- Carolyn Musholt
- Adnan Mushtaq
- Michael R. Mustard
- Wayland J Mutter
- Arshad R Muzaffar
All providers in Quincy, IL · Anatomic Pathology & Clinical Pathology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.