Individual provider Active NPI

Tracy L Rockefeller, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakeville, PA
National Provider Identifier
1346472057
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP010412 Issued in PA
Practice address
1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone
(570) 647-9277
Fax
(570) 227-0084
NPI assigned
Aug 13, 2009
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP010412 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP010412 PA Primary

Addresses

Primary practice location

1258 Purdytown Tpke
Lakeville, PA 18438-6793

Mailing address

1154 Beaver Lake Dr
Lake Ariel, PA 18436-8013
Phone (267) 401-0669

Other practice location 1

1154 Beaver Lake Dr
Lake Ariel, PA 18436-8013
Phone (267) 401-0669

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
I20110630000366 PA Practitioner - Nurse Practitioner 8729266325 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arbor Vitae Behavioral Health, LLCGroup PAC ID 9537529789, 5 clinicians

Practice addresses (Care Compare)

1258 Purdytown Tpke
Lakeville, PA 18438-6793
Phone (570) 647-9277

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Aug 20, 2018 Accepting new patients
Joseph Dantonio MD PC CurrentSince Jun 1, 2015 Accepting new patients
Arbor Vitae Behavioral Health, LLC CurrentSince Jun 1, 2024 Accepting new patients
Glenmaura Holdings, LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

1258 Purdytown Tpke
Lakeville, PA 18438
Phone (570) 226-1963

1258 Purdytown Tpke
Lowr
Lakeville, PA 18438

615 W Main St
Lansdale, PA 19446
Phone (215) 361-8063

60 Glenmaura National Blvd
Moosic, PA 18507
Phone (570) 301-5000

1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300

8 Church St
Wilkes Barre, PA 18702
Phone (570) 808-3700

8 Church St
Ofc
Wilkes Barre, PA 18702
Phone (570) 808-3100

Organizations & group practices 5

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": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1346472057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1154 BEAVER LAKE DR",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184368013",
            "telephone_number": "267-401-0669",
            "fax_number": "570-936-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-647-9277",
            "fax_number": "570-227-0084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1154 Beaver Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Ariel",
            "state": "PA",
            "postal_code": "184368013",
            "country_code": "US",
            "telephone_number": "267-401-0669",
            "fax_number": "570-936-7357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKEFELLER",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP010412",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP010412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, PA

Sources for this page

Verify at the official NPI Registry.