Individual provider Active NPI

Tracy E Smith, PA-C

  • Surgical Physician Assistant
  • Rochester, NY
National Provider Identifier
1356591887
Registry record updated Nov 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
012790 Issued in NY
Practice address
1425 Portland Ave
Rochester, NY 14621-3001
Phone
(585) 922-3963
NPI assigned
Sep 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 012790 NY Primary

Addresses

Primary practice location

1425 Portland Ave
Rochester, NY 14621-3001

Mailing address

1425 Portland Ave
Rochester, NY 14621-3001

Other practice location 1

1200 Driving Park Ave
Newark, NY 14513-1090
Phone (315) 789-5061

Other practice location 2

875 Pre Emption Rd
Geneva, NY 14456-2042
Phone (315) 789-5061

Other practice location 3

1200 Driving Park Ave Ste 4
Newark, NY 14513-1090
Phone (315) 359-2696

Other practice location 4

401 S Main St
Canandaigua, NY 14424-2126
Phone (585) 412-6491

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090402000601 NY Practitioner - Physician Assistant 1052468303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rochester General HospitalGroup PAC ID 0244149474, 1,192 clinicians

Practice addresses (Care Compare)

1425 Portland Ave
Rochester, NY 14621-3001
Phone (585) 922-4000

1425 Portland Ave
Rochester, NY 14621-3011
Phone (585) 922-4000

Hospital & facility affiliations

  • Rochester General Hospital Hospital, Rochester, NY, CCN 330125

Merit-based Incentive Payment System (MIPS)

Final score
96.62 of 100Reported as apm
Quality
74.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012790NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rochester General Hospital CurrentSince Oct 3, 2008 Accepting new patients
Rochester General Hospital CurrentSince Oct 3, 2008 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Oct 16, 2019 Accepting new patients
Western New York Medical Practice, P.C. CurrentSince Oct 16, 2019 Accepting new patients

Locations

401 S Main St
Canandaigua, NY 14424
Phone (585) 394-1875

875 Pre Emption Rd
Geneva, NY 14456
Phone (315) 789-5061

1200 Driving Park Ave
Ste 4
Newark, NY 14513
Phone (315) 359-2629

1200 Driving Park Ave
Newark, NY 14513
Phone (315) 332-2266

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573776000000",
    "number": "1356591887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-3963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Driving Park Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131090",
            "country_code": "US",
            "telephone_number": "315-789-5061",
            "fax_number": "315-789-5071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Pre Emption Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "NY",
            "postal_code": "144562042",
            "country_code": "US",
            "telephone_number": "315-789-5061",
            "fax_number": "315-789-5071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Driving Park Ave Ste 4",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NY",
            "postal_code": "145131090",
            "country_code": "US",
            "telephone_number": "315-359-2696",
            "fax_number": "315-359-2699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 S Main St",
            "address_purpose": "LOCATION",
            "city": "Canandaigua",
            "state": "NY",
            "postal_code": "144242126",
            "country_code": "US",
            "telephone_number": "585-412-6491",
            "fax_number": "585-412-6492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TRACY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-20",
        "last_updated": "2019-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "012790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.