Active NPI
Tracy Lynn Crookston, PA-C
- Medical Physician Assistant
- Hartford, CT
National Provider Identifier
1295401511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 005439
- Practice address
- 80 Seymour Street
Hartford Hospital Surgery Dept
Hartford, CT 06102-8000 - Phone
- (860) 972-5022
- NPI assigned
- Aug 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 005439 | CT | Primary |
Addresses
Primary practice location
80 Seymour Street
Hartford Hospital Surgery Dept
Hartford, CT 06102-8000
Mailing address
80 Seymour Street
Hartford Hospital Surgery Dept
Hartford, CT 06102-8000
Phone (860) 972-5022
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211026001499 | CT | Practitioner - Physician Assistant | 7719375690 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hartford Hospital
Practice addresses (Care Compare)
80 Seymour St
Hartford, CT 06102-8000
Hospital & facility affiliations
- Hartford Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.63 of 100
- Quality
- 75.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.44
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005439 | CT | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Hospital | Current | Accepting new patients |
Locations
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Organizations & group practices 6
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.
-
- Skilled Nursing Facility
- Newington, CT
- NPI 1700810777
-
- Community/Retail Pharmacy
- Hartford, CT
- NPI 1790183515
-
- Psychiatric Hospital Unit
- Hartford, CT
- NPI 1861652604
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1295401511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 SEYMOUR STREET",
"address_2": "HARTFORD HOSPITAL SURGERY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061028000",
"telephone_number": "860-972-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SEYMOUR STREET",
"address_2": "HARTFORD HOSPITAL SURGERY DEPT",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061028000",
"telephone_number": "860-972-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROOKSTON",
"first_name": "TRACY",
"middle_name": "LYNN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-17",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CT",
"license": "005439",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.