Individual provider Active NPI

Caitlynn Nicole Tracy

  • Physician Assistant
  • New City, NY
National Provider Identifier
1396461646
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
032971 Issued in NY
Practice address
200 E Eckerson Rd
New City, NY 10956-7153
Phone
(845) 352-0500
NPI assigned
Oct 18, 2022
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4638 SC
Physician Assistant 363A00000X 032971 NY Primary

Addresses

Primary practice location

200 E Eckerson Rd
New City, NY 10956-7153

Mailing address

200 E Eckerson Rd
New City, NY 10956-7153
Phone (845) 352-0500

Other practice location 1

3016 Longtown Commons Dr Ste 300
Columbia, SC 29229-7864
Phone (803) 744-4900

Other practice location 2

2828 Bayboro St
Loris, SC 29569-2710
Phone (843) 716-2229

Other practice location 3

3650 Express Dr
Shallotte, NC 28470-6501
Phone (910) 754-2229

Other practice location 4

2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815
Phone (803) 744-4900

Other practice location 5

105 Brevard Pkwy
Lexington, SC 29073-7265
Phone (803) 951-1880

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address ctracy85634@direct.lexmed.com
Direct Messaging Address ctracy85634@direct.lexmed.com
Direct Messaging Address ctracy85634@direct.lexmed.com
Direct Messaging Address ctracy85634@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230206001037 SC Practitioner - Physician Assistant 0547632317 Reassigns benefits to 1 organization
I20260327003074 NY Practitioner - Physician Assistant 0547632317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 S Shore Dr
Suite 200
East Haven, CT 06512-5606

200 E Eckerson Rd
New City, NY 10956-7156

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4638SCMDClinical Social Worker
032971NYMDPharmacist
PA4638SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc CurrentSince Sep 3, 2023 Accepting new patients
Seashore Pediatrics PastSince Oct 1, 2022 Accepting new patients

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": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1396461646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E ECKERSON RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109567153",
            "telephone_number": "845-352-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E ECKERSON RD",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109567153",
            "telephone_number": "845-352-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3016 Longtown Commons Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292297864",
            "country_code": "US",
            "telephone_number": "803-744-4900",
            "fax_number": "803-744-4935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2828 Bayboro St",
            "address_purpose": "LOCATION",
            "city": "Loris",
            "state": "SC",
            "postal_code": "295692710",
            "country_code": "US",
            "telephone_number": "843-716-2229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3650 Express Dr",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284706501",
            "country_code": "US",
            "telephone_number": "910-754-2229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2728 Sunset Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694815",
            "country_code": "US",
            "telephone_number": "803-744-4900",
            "fax_number": "803-744-4938",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Brevard Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "SC",
            "postal_code": "290737265",
            "country_code": "US",
            "telephone_number": "803-951-1880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACY",
        "first_name": "CAITLYNN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "PA4638",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "032971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctracy85634@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "105 Brevard Pkwy",
            "city": "Lexington",
            "state": "SC",
            "country_code": "US",
            "postal_code": "290737265",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctracy85634@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctracy85634@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctracy85634@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.