Individual provider Active NPI

Tracey W Alphin, PA

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1194094375
Registry record updated Sep 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001366A Issued in IN
Practice address
2301 N Meridian St
Indianapolis, IN 46208-5729
Phone
(317) 847-4366
Fax
(833) 464-4582
NPI assigned
Dec 19, 2011
Last updated
Sep 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001366A IN Primary

Addresses

Primary practice location

2301 N Meridian St
Indianapolis, IN 46208-5729

Mailing address

7920 Dartmouth Rd
Indianapolis, IN 46260-2819
Phone (239) 246-7711

Other practice location 1

26026 W 12 Mile Rd Ste 202
Southfield, MI 48034-1783
Phone (833) 904-2273

Other practice location 2

15416 N Florida Ave Ste 203
Tampa, FL 33613-1239
Phone (833) 904-2273

Other practice location 3

16115 LaSalle Street
South Holland, IL 60473
Phone (833) 904-2273

Other practice location 4

500 E Main St Ste 105
Columbus, OH 43215-5619
Phone (833) 904-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL, MI, OH4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20111230000050 IN Practitioner - Physician Assistant 4385810076 Reassigns benefits to 1 organization
I20240211000085 IL Practitioner - Physician Assistant 4385810076 Reassigns benefits to 1 organization
I20250617002163 MI Practitioner - Physician Assistant 4385810076 Reassigns benefits to 1 organization
I20260131000111 OH Practitioner - Physician Assistant 4385810076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

495 Flatbush Ave
Brooklyn, NY 11225-3706

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cityblock Medical Practice, LLC CurrentSince Jan 1, 2026 Accepting new patients
Major Hospital Past Accepting new patients

Locations

495 Flatbush Ave
Ste C5
Brooklyn, NY 11225
Phone (347) 463-5529

5049 Crookshank Rd
Cincinnati, OH 45238
Phone (513) 451-0097

500 E Main St
Ste 105
Columbus, OH 43215
Phone (614) 695-5060

800 N High St
Ste 4102
Columbus, OH 43215
Phone (347) 463-5529

Interoperability endpoints

  • Direct secure messaging: tracey.alphin.1@27775.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1194094375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 DARTMOUTH RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602819",
            "telephone_number": "239-246-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462085729",
            "telephone_number": "317-847-4366",
            "fax_number": "833-464-4582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26026 W 12 Mile Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480341783",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15416 N Florida Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336131239",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16115 LaSalle Street",
            "address_purpose": "LOCATION",
            "city": "South Holland",
            "state": "IL",
            "postal_code": "60473",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 E Main St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432155619",
            "country_code": "US",
            "telephone_number": "833-904-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALPHIN",
        "first_name": "TRACEY",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001366A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.