Individual provider Active NPI

Traci Green, APRN

  • Nurse Practitioner
  • New Haven, CT
National Provider Identifier
1205854213
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
002298 Issued in CT
Practice address
20 York Street
Yale New Haven Hospital Heart Center
New Haven, CT 06504
Phone
(203) 688-1690
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 002298 CT Primary

Addresses

Primary practice location

20 York Street
Yale New Haven Hospital Heart Center
New Haven, CT 06504

Mailing address

50 Overbrook Rd
Madison, CT 06443-1953

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20130219000070 CT Practitioner - Nurse Practitioner 2860647062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.36 of 100Reported as group
Quality
77.36
Promoting interoperability
100
Improvement activities
40
Cost
74.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002298CTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc. Nurse Practitioner CurrentSince Oct 1, 2012 Accepting new patients
Yale University CurrentSince Apr 1, 2015 Accepting new patients
Yale University CurrentSince Apr 1, 2015 Accepting new patients

Locations

300 George St
#6
New Haven, CT 06511
Phone (203) 737-6293

20 York St
Unit CB2041
New Haven, CT 06510
Phone (203) 688-4741

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

20 York St
North Haven, CT 06510
Phone (203) 688-2433

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: tgreen3282@direct.ynhh.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205854213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 OVERBROOK RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET",
            "address_2": "YALE NEW HAVEN HOSPITAL HEART CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06504",
            "telephone_number": "203-688-1690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "TRACI",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "002298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.