Debra A Tristram, MD

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

9801788 Issued in NC

Practice address

2150 Herbert CT
Ecu Physicians Pediatric Specialty Care Clinic
Greenville, NC 27834-3736

Phone

(252) 744-5437

Fax

(252) 744-1514

NPI assigned

Nov 28, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1497921688
  Medicare reassignment NPD
• Albany Medical College

  • Urgent Care Clinic/Center
  • Albany, NY
  • NPI 1386038925
  NPD
• Albany Medical College

  • Allergy & Immunology Physician
  • Albany, NY
  • NPI 1386689248
  NPD
• Albany Medical College

  • Physical Medicine & Rehabilitation Physician
  • Albany, NY
  • NPI 1629008537
  NPD
• Albany Medical College

  • Pediatrics Physician
  • Albany, NY
  • NPI 1750315636

  Pediatric Infectious Diseases

  NPD

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1306829015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751069",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751069",
            "telephone_number": "252-744-3253",
            "fax_number": "252-744-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HERBERT CT",
            "address_2": "ECU PHYSICIANS PEDIATRIC SPECIALTY CARE CLINIC",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278343736",
            "telephone_number": "252-744-5437",
            "fax_number": "252-744-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRISTRAM",
        "first_name": "DEBRA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NC",
            "license": "9801788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "11649",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911649",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "370015918",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Tripp
• Penny C Tripp, CPED
• Trisha-Loray Abaro Aprecio D.D.S., P.C.
• David Trisler, D.O.
• Violet Emma Lucia Trisolini
• Triumph Home Care Services, LLC
• Lorna Marjorie Troost, PT, DPT
• Domonique Desiree' Trotter, CNM
• Gary Marc Trube, PAC
• True East Home Care LLC

• Pediatric Infectious Diseases Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Pediatric Infectious Diseases Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.