NPIMap

Individual provider Active NPI

Tracy Heffron, PA

  • Physician Assistant
  • Geneva, NY
National Provider Identifier
1194889386
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008185 Issued in NY
Practice address
200 North St
Suite 101
Geneva, NY 14456-1561
Phone
(315) 787-5100
Fax
(315) 787-5108
NPI assigned
Dec 21, 2006
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8185 NY
Physician Assistant 363A00000X 008185 NY Primary

Addresses

Primary practice location

200 North St
Suite 101
Geneva, NY 14456-1561

Mailing address

200 North St
Suite 101
Geneva, NY 14456-1561
Phone (315) 787-5100

Other identifiers 4

IdentifierTypeStateIssuer
970029958OtherNYR.R. MEDICARE
110857BJOtherNYPREFERRED CARE
02384912MedicaidNY
P019008185OtherNYBLUE CHOICE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address theffron119810@direct.urmc.rochester.edu Direct
Direct Messaging Address theffron119810@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070814000758 NY Practitioner - Physician Assistant 4880785252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

1160 Corporate Dr
Farmington, NY 14425-9534
Phone (585) 924-1510

15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

699 S Main St
Suite 5
Canandaigua, NY 14424-2208
Phone (585) 396-6050

800 W Miller St
Suite 11
Newark, NY 14513-1354
Phone (315) 226-8900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8185NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester CurrentSince Feb 26, 2018 Accepting new patients
University of Rochester CurrentSince Feb 26, 2018 Accepting new patients
The Frederick Ferris Thompson Hospital CurrentSince May 20, 2010 Accepting new patients
Western New York Medical Practice P.C. Past Accepting new patients
Interlakes Oncology & Hematology PC Past Accepting new patients

Locations

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560

Organizations & group practices 6

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1194889386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 101",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5100",
            "fax_number": "315-787-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NORTH ST",
            "address_2": "SUITE 101",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561561",
            "telephone_number": "315-787-5100",
            "fax_number": "315-787-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFRON",
        "first_name": "TRACY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "8185",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "008185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "970029958",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "110857BJ",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02384912",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P019008185",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theffron119810@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "theffron119810@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Geneva, NY

Sources for this page

Verify at the official NPI Registry.