Tracy Georgis, R.N., N.P.

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

307097 Issued in CA

Practice address

1121 Via Zumaya
Palos Verdes Estates, CA 90274

Phone

(858) 525-1580

Fax

(310) 544-0395

NPI assigned

Jul 18, 2008

Last updated

Jul 18, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracy.georgis@398008301912068.direct.elationemr.com

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.

• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593
  Medicare reassignment NPD
• Healthcare Partners Affiliates Medical Group

  dba Optum

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1326203373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 VIA ZUMAYA",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "90274",
            "telephone_number": "858-525-1580",
            "fax_number": "310-544-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 VIA ZUMAYA",
            "city": "PALOS VERDES ESTATES",
            "state": "CA",
            "postal_code": "90274",
            "telephone_number": "858-525-1580",
            "fax_number": "310-544-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGIS",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "R.N., N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "307097",
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "CA",
            "license": "307097",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "307097",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "307097",
            "primary": true
        },
        {
            "code": "363LS0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, School",
            "state": "CA",
            "license": "307097",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "307097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin M. Ehtessabian, D.D.S.
• Ryan Ali Ehtessabian, M.S., CNS
• Patricia Alice Elder, RN, IBCLC
• Penny Lew Fevergeon, M.S., R.D.
• Fresch Services LLC. (A Place at Home)
• Andrew Ghadimi, DDS
• Aimee M Goeppner, HEALTH COACH
• Gina M Golden-Tangalakis, PH.D.
• Robert H Goldman, M.D.
• Jason R Gong, DDS

• Primary Care Nurse Practitioner in Palos Verdes Estates, CA
• Providers in Palos Verdes Estates, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.