Individual provider Active NPI

Tracy L Agnew, CRNP

  • Nurse Practitioner
  • Erie, PA
National Provider Identifier
1306821715
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TP005758B Issued in PA
Practice address
145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone
(814) 452-2767
Fax
(814) 459-2976
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TP005758B PA Primary

Addresses

Primary practice location

145 W 23Rd St Ste 101
Erie, PA 16502-2858

Mailing address

145 W 23Rd St Ste 101
Erie, PA 16502-2858
Phone (814) 452-2767

Other identifiers 2

IdentifierTypeStateIssuer
CAQHOther12227525
102262534MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tagnew148711@direct.ahn.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040412000331 PA Practitioner - Nurse Practitioner 8820082175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 W 23Rd St
101 Digestive Diseases of NW PA
Erie, PA 16502-2858
Phone (814) 452-2767

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TP005758BPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Education and Research Institute Inc CurrentSince Apr 1, 2005 Accepting new patients
Saint Vincent Medical Education and Researach Institute Past Accepting new patients
Saint Vincent Medical Education and Research Institute Past Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

3530 Peach St
Ste LL1
Erie, PA 16508

145 W 23rd St
Ste 101
Erie, PA 16502
Phone (814) 452-2767

2315 Myrtle St
Ste 290
Erie, PA 16502
Phone (814) 454-1142

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.

Hospital & facility affiliations 1

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": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1306821715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-2767",
            "fax_number": "814-459-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 W 23RD ST STE 101",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022858",
            "telephone_number": "814-452-2767",
            "fax_number": "814-459-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "TP005758B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "12227525",
            "identifier": "CAQH",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102262534",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tagnew148711@direct.ahn.org",
            "affiliation": "N",
            "address_1": "145 W 23rd St Ste 101",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165022858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.