Tracy Ann Kelly, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105943 Issued in FL

Practice address

3000 SW 148TH Ave
Suite 200
Miramar, FL 33027-4169

Phone

(703) 244-9469

NPI assigned

Apr 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Ms. Tracy Ann Beverley Former name

Medicare fee-for-service enrollment

Enrolled in VA

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 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vann-Virginia Center for Orthopaedics PCGroup PAC ID 9133115397, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sentara Norfolk General Hospital Hospital, Norfolk, VA, CCN 490007
• Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119

Merit-based Incentive Payment System (MIPS)

Final score

92.32 of 100Reported as group

Quality

87.23

Promoting interoperability

100

Improvement activities

40

Cost

87.16

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Vann-Virginia Center for Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Norfolk, VA
  • NPI 1639125271
  Medicare reassignment Care Compare group
• Vann-Virginia Center for Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Virginia Beach, VA
  • NPI 1588605422
  NPD
• Vann-Virginia Center for Orthopaedics PC

  • Orthopaedic Surgery Physician
  • Kill Devil Hills, NC
  • NPI 1669169983
  NPD
• Okun and Maddalon M.D. PA

  • Specialist
  • Brandon, FL
  • NPI 1407891302
  NPD (past)

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

• Sentara Hospitals

  • Air Ambulance
  • Norfolk, VA
  • NPI 1235205147

  Hospital

  Care Compare affiliation
• Sentara Hospitals

  • General Acute Care Hospital
  • Norfolk, VA
  • NPI 1437119310
  Care Compare affiliation
• Sentara Princess Anne Hospital

  • General Acute Care Hospital
  • Virginia Beach, VA
  • NPI 1528028396
  Care Compare affiliation

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1194949388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 SW 148TH AVE",
            "address_2": "SUITE 200",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274169",
            "telephone_number": "703-244-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SW 148TH AVE",
            "address_2": "SUITE 200",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274169",
            "telephone_number": "703-244-9469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1975 Glenn Mitchell Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234560167",
            "country_code": "US",
            "telephone_number": "757-321-3300",
            "fax_number": "757-321-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "VA",
            "license": "012000974",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110003365",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105943",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BEVERLEY",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• KBS Medical PA
• KBS Medical PA
• Kulravee P Keegan, D.O.
• Araly Alexis Kelly, FNP
• Tara Kelly, A.R.N.P.
• Sabrina Kemp
• Kenneth O. Karp, MD, PA
• Key Solutions Network LLC
• Ammar A Khalil, LPTA
• Kiran Khan Paracha

• Physician Assistant in Miramar, FL
• Providers in Miramar, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; 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.