Individual provider Active NPI

Tracy Rae Hart, LICSW

  • Clinical Social Worker
  • Wakefield, RI
National Provider Identifier
1396220216
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW01003 Issued in RI
Practice address
24 Salt Pond Road
Suite H1
Wakefield, RI 02879
Phone
(401) 789-3694
Fax
(401) 789-3748
NPI assigned
Sep 26, 2018
Last updated
Sep 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW01003 RI Primary

Addresses

Primary practice location

24 Salt Pond Road
Suite H1
Wakefield, RI 02879

Mailing address

24 Salt Pond Road
Suite H1
Wakefield, RI 02879
Phone (401) 789-3694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200213002668 RI Practitioner - Clinical Social Worker 4789010505 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Consultants of South County IncGroup PAC ID 8426063553, 14 clinicians

Practice addresses (Care Compare)

24 Salt Pond Rd
D4
Wakefield, RI 02879-4334
Phone (401) 789-3694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW01003RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Consultants of South County Inc CurrentSince Feb 1, 2020 Accepting new patients
Align Physical Therapy CurrentSince Feb 1, 2020 Accepting new patients

Locations

24 Salt Pond Rd
Ste D4
Wakefield, RI 02879
Phone (401) 667-4965

24 Salt Pond Rd
Ste H1
Wakefield, RI 02879
Phone (401) 789-2424

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, 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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1396220216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 SALT POND ROAD",
            "address_2": "SUITE H1",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-789-3694",
            "fax_number": "401-789-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 SALT POND ROAD",
            "address_2": "SUITE H1",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-789-3694",
            "fax_number": "401-789-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "TRACY",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW01003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

Verify at the official NPI Registry.