Individual provider Active NPI

Traci Diana Hill, APN

  • Gerontology Nurse Practitioner
  • Whiting, NJ
National Provider Identifier
1306366455
Registry record updated Jun 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00708200 Issued in NJ
Practice address
401 Lacey Rd Ste B
Whiting, NJ 08759-1386
Phone
(732) 849-1075
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00708200 NJ Primary

Addresses

Primary practice location

401 Lacey Rd Ste B
Whiting, NJ 08759-1386

Mailing address

401 Lacey Road
Suite B
Whiting, NJ 08759
Phone (732) 849-1075

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013000264 NJ Practitioner - Nurse Practitioner 5890060008 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BC Medical Care LLC 2 clinicians

Practice addresses (Care Compare)

1747 Hooper Ave
Suite 8
Toms River, NJ 08753-8130
Phone (732) 255-6777

Hospital & facility affiliations

  • Community Medical Center Hospital, Toms River, NJ, CCN 310041
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ00708200NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BC Medical Care LLC CurrentSince Aug 29, 2018 Accepting new patients
Ocean Medical Group,P.a. CurrentSince Sep 1, 2017 Accepting new patients
Omg Senior Care LLC PastSince Jul 22, 2022 Accepting new patients

Locations

1747 Hooper Ave
Ste 8
Toms River, NJ 08753
Phone (732) 255-6777

401 Lacey Rd
Ste B
Whiting, NJ 08759
Phone (732) 849-1075

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGGAAA

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.

Hospital & facility affiliations 3

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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497916800000",
    "number": "1306366455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LACEY ROAD",
            "address_2": "SUITE B",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "08759",
            "telephone_number": "732-849-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LACEY RD STE B",
            "city": "WHITING",
            "state": "NJ",
            "postal_code": "087591386",
            "telephone_number": "732-849-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "TRACI",
        "middle_name": "DIANA",
        "name_prefix": "Miss",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2017-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00708200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiting, NJ

Sources for this page

Verify at the official NPI Registry.