Individual provider Active NPI

Tracy Kay O'Shea, APRN-CNP #58842

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1336788850
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58842 Issued in NM
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-2111
NPI assigned
Dec 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 58842 NM Primary
Registered Nurse 163W00000X R64921 NM

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

4520 Martinsburg Rd NW
Albuquerque, NM 87120-3857
Phone (505) 385-4981

Other names 1

  • Ms. Tracy Kay Johnson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20200331000027 NM Practitioner - Nurse Practitioner 4082043807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unm HospitalGroup PAC ID 7618889528, 394 clinicians

Practice addresses (Care Compare)

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2644

Hospital & facility affiliations

  • Unm Hospital Hospital, Albuquerque, NM, CCN 320001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R64921NMMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Hospital CurrentSince Jan 21, 2022 Accepting new patients
Unm Hospital CurrentSince Jan 21, 2022 Accepting new patients

Locations

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

2211 Lomas Blvd NE
Fl 5
Albuquerque, NM 87106
Phone (505) 272-2273

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 2

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 2

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": "1577750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1336788850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 MARTINSBURG RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871203857",
            "telephone_number": "505-385-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SHEA",
        "first_name": "TRACY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "APRN-CNP #58842",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-31",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "58842",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R64921",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "JOHNSON",
            "middle_name": "KAY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.