Individual provider Active NPI

Bridget Tracy, M.D.

  • Internal Medicine Physician
  • Red Bank, NJ
National Provider Identifier
1366670473
Registry record updated Jan 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA10134700 Issued in NJ
Practice address
1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone
(732) 450-2728
Fax
(732) 530-3900
NPI assigned
Jun 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP01795 RI
Internal Medicine Physician 207R00000X 265121 NY
Internal Medicine Physician 207R00000X 25MA10134700 NJ Primary

Addresses

Primary practice location

1 Riverview PLZ
Red Bank, NJ 07701-1864

Mailing address

1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (732) 450-2728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024003425 NJ Practitioner - Hospice/Palliative Care 6901030998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10134700NJMDInternal Medicine Physician
LP01795RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MSK Monmouth CurrentSince Jan 16, 2018 Accepting new patients

Locations

480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

Organizations & group practices 1

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516060800000",
    "number": "1366670473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864",
            "telephone_number": "732-450-2728",
            "fax_number": "732-530-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RIVERVIEW PLZ",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011864",
            "telephone_number": "732-450-2728",
            "fax_number": "732-530-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "BRIDGET",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2018-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01795",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "265121",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10134700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.