Individual provider Active NPI

Tracy E Schiller, P.A.

  • Medical Physician Assistant
  • Lake Worth, FL
National Provider Identifier
1275974081
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106935 Issued in FL
Practice address
3618 Lantana Rd
Lake Worth, FL 33462-2246
Phone
(561) 296-1188
NPI assigned
Jul 9, 2013
Last updated
Jun 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106935 FL Primary
Medical Physician Assistant 363AM0700X 002388 IA

Addresses

Primary practice location

3618 Lantana Rd
Lake Worth, FL 33462-2246

Mailing address

3618 Lantana Rd
Lake Worth, FL 33462-2246
Phone (561) 296-1188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160606000830 IA Practitioner - Physician Assistant 7416267943 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002388IAMDSpeech-Language Pathologist
PA9106935FLMDMedical Physician Assistant
2443MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salahuddin Syed MD PC Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince May 1, 2017 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince May 1, 2017 Accepting new patients

Locations

3 S 4th Ave
Marshalltown, IA 50158
Phone (641) 754-5145

405 E Main St
Marshalltown, IA 50158
Phone (641) 753-2752

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1275974081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 LANTANA RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334622246",
            "telephone_number": "561-296-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 LANTANA RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334622246",
            "telephone_number": "561-296-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "TRACY",
        "middle_name": "E",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106935",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "002388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.