Individual provider Active NPI

Tracy Macintyre Raykovicz, O.D.

  • Optometrist
  • Monroe, NC
National Provider Identifier
1275587495
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1894 Issued in NC
Practice address
2115 W Roosevelt Blvd
Monroe, NC 28110-2737
Phone
(704) 238-1849
Fax
(704) 238-1850
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1894 NC Primary

Addresses

Primary practice location

2115 W Roosevelt Blvd
Monroe, NC 28110-2737

Mailing address

815 Deercross LN
Waxhaw, NC 28173-6603
Phone (704) 847-7474

Other identifiers 1

IdentifierTypeStateIssuer
98478700MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000525 NC Practitioner - Optometry 0840203428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blink Eye Care and Eye Wear OD PAGroup PAC ID 4587703582, 3 clinicians

Practice addresses (Care Compare)

16618 Riverstone Way
Charlotte, NC 28277-5746
Phone (704) 817-3800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC1894NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blink Eye Care and Eye Wear OD., PA Optometrist CurrentSince Nov 16, 2009 Accepting new patients
J & L Optometric Assocs.PA Optometrist PastSince Jun 23, 2006 Accepting new patients

Locations

16618 Riverstone Way
Charlotte, NC 28277
Phone (704) 817-3800

Organizations & group practices 2

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1275587495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 DEERCROSS LN",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736603",
            "telephone_number": "704-847-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281102737",
            "telephone_number": "704-238-1849",
            "fax_number": "704-238-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYKOVICZ",
        "first_name": "TRACY",
        "middle_name": "MACINTYRE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "98478700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.