Individual provider Active NPI

Tracy Lee McMonigle, PA-C /MPAS

  • Physician Assistant
  • Agana HTS, GU
National Provider Identifier
1366422396
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105808 Issued in FL
Practice address
US Naval Hospital Guam
Farenholt Ave BLDG K-1
Agana HTS, GU 96919
Phone
(671) 344-9619
NPI assigned
Jan 17, 2006
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105808 FL Primary

Addresses

Primary practice location

US Naval Hospital Guam
Farenholt Ave BLDG K-1
Agana HTS, GU 96919

Mailing address

US Naval Hospital Guam
Farenholt Ave BLDG K-1
Agana HTS, GU 96919
Phone (671) 344-9619

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110727000736 FL Practitioner - Physician Assistant 6002084563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Jun 29, 2023 Accepting new patients
Cep America LLC CurrentSince Jun 29, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1366422396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "US NAVAL HOSPITAL GUAM",
            "address_2": "FARENHOLT AVE BLDG K-1",
            "city": "AGANA HTS",
            "state": "GU",
            "postal_code": "96919",
            "telephone_number": "671-344-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US NAVAL HOSPITAL GUAM",
            "address_2": "FARENHOLT AVE BLDG K-1",
            "city": "AGANA HTS",
            "state": "GU",
            "postal_code": "96919",
            "telephone_number": "671-344-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMONIGLE",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C  /MPAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agana HTS, GU

Sources for this page

Verify at the official NPI Registry.