Tracy Lyn Vedder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084310-1 Issued in NY

Practice address

987 R C Hoag Dr
Salamanca, NY 14779-1365

Phone

(716) 945-9001

Fax

(716) 945-0790

NPI assigned

Jan 3, 2017

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 names 1

• Miss Tracy Lyn Holmes Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Suburban Adult Services Inc.Group PAC ID 1658378583, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Suburban Adult Services-Inc.

  • Developmentally Disabled Services Day Training Agency
  • Elma, NY
  • NPI 1528081734

  NY

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1316482102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 FRENCH RD",
            "address_2": "PO BOX 279",
            "city": "YORKSHIRE",
            "state": "NY",
            "postal_code": "141738005",
            "telephone_number": "716-353-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 R C HOAG DR",
            "city": "SALAMANCA",
            "state": "NY",
            "postal_code": "147791365",
            "telephone_number": "716-945-9001",
            "fax_number": "716-945-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDDER",
        "first_name": "TRACY",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084310-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "HOLMES",
            "middle_name": "LYN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Thorne, DDS
• Katee E Tiballi, PHARMD, RPH
• Lisa Traina, NP
• Tri-County Dental, PC
• Hannah Ulinger
• Christi L Visneski, RN
• Rachel Walczyk, PA
• Allen J Ward, LCSW
• Cheryl Wier, MSN RN
• David Wilczewski, RPH

• All providers in Salamanca, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.

Verify at the official NPI Registry.