NPIMap

Individual provider Active NPI

Traci L. Mahoney, PA

  • Physician Assistant
  • Charlottesville, VA
National Provider Identifier
1376829184
Registry record updated Feb 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110006132 Issued in VA
Practice address
545 Ray C Hunt Dr Ste 140
Charlottesville, VA 22903
Phone
(434) 243-0245
Fax
(434) 243-0242
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2023

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 0110006132 VA Primary

Addresses

Primary practice location

545 Ray C Hunt Dr Ste 140
Charlottesville, VA 22903

Mailing address

300 Hickman Rd Ste 202
Charlottesville, VA 22911-3554
Phone (434) 326-5815

Other practice location 1

300 Hickman Rd Ste 202
Charlottesville, VA 22911-3554
Phone (434) 326-5815

Other identifiers 2

IdentifierTypeStateIssuer
1376829184MedicaidVA
03427667MedicaidNY

Other names 1

  • Traci Lynn Baldwin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180529000697 VA Practitioner - Physician Assistant 8325205248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Thunder Orthopedics, LLCGroup PAC ID 3870962137, 3 clinicians

Practice addresses (Care Compare)

250 Merchant Walk SQ
Charlottesville, VA 22902-6511
Phone (434) 328-4900

300 Hickman Rd
Suite 202
Charlottesville, VA 22911-3554
Phone (434) 326-5815

Hospital & facility affiliations

  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077
  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004
  • Uva Health Culpeper Medical Center Hospital, Culpeper, VA, CCN 490019
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
77.04
Promoting interoperability
100
Improvement activities
40
Cost
74.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015278NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Virginia Physicians Group CurrentSince May 21, 2018 Accepting new patients

Locations

545 Ray C Hunt Dr
Ste 140
Charlottesvle, VA 22903
Phone (434) 243-9198

1215 Lee St
Fl 8
Charlottesvle, VA 22908
Phone (434) 924-2500

Interoperability endpoints

  • Direct secure messaging: traci.mahoney.1@27835.direct.athenahealth.com

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676678400000",
    "number": "1376829184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HICKMAN RD STE 202",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229113554",
            "telephone_number": "434-326-5815",
            "fax_number": "434-326-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 RAY C HUNT DR STE 140",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22903",
            "telephone_number": "434-243-0245",
            "fax_number": "434-243-0242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hickman Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229113554",
            "country_code": "US",
            "telephone_number": "434-326-5815",
            "fax_number": "434-326-5820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "TRACI",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2023-02-18",
        "certification_date": "2023-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376829184",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03427667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "BALDWIN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.