Individual provider Active NPI

Tracy B Verrico, D.O.

  • Gynecology Physician
  • Oradell, NJ
National Provider Identifier
1205898830
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
25MB08210000 Issued in NJ
Practice address
481 Kinderkamack Rd
Oradell, NJ 07649-1519
Phone
(551) 278-5898
Fax
(551) 236-1771
NPI assigned
Apr 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 25MB08210000 NJ Primary

Addresses

Primary practice location

481 Kinderkamack Rd
Oradell, NJ 07649-1519

Mailing address

88 Horizon Ter
Hillsdale, NJ 07642-1016
Phone (551) 278-5898

Other practice location 1

31-00 Broadway
Fair Lawn, NJ 07410-3963
Phone (201) 796-2255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127002291 NJ Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 6204851082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
25MB08210000NJMDGynecology Physician

Interoperability endpoints

  • Direct secure messaging: tracy.verrico.1@26778.direct.athenahealth.com
  • Direct secure messaging: tverrico190335@ahs.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1205898830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 HORIZON TER",
            "city": "HILLSDALE",
            "state": "NJ",
            "postal_code": "076421016",
            "telephone_number": "551-278-5898",
            "fax_number": "551-236-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 KINDERKAMACK RD",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491519",
            "telephone_number": "551-278-5898",
            "fax_number": "551-236-1771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31-00 Broadway",
            "address_purpose": "LOCATION",
            "city": "Fair Lawn",
            "state": "NJ",
            "postal_code": "074103963",
            "country_code": "US",
            "telephone_number": "201-796-2255",
            "fax_number": "201-796-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERRICO",
        "first_name": "TRACY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NJ",
            "license": "25MB08210000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oradell, NJ

Sources for this page

Verify at the official NPI Registry.