Individual provider Active NPI

Wende Tracey-Allen, P.A.

  • Physician Assistant
  • Rockville, MD
National Provider Identifier
1407056781
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0001446 Issued in MD
Practice address
15001 Shady Grove Rd
Suite 310
Rockville, MD 20850-6352
Phone
(301) 340-1188
Fax
(301) 340-6478
NPI assigned
Jul 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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 C0001446 MD Primary

Addresses

Primary practice location

15001 Shady Grove Rd
Suite 310
Rockville, MD 20850-6352

Mailing address

6569 N Charles St
PPW # 406
Baltimore, MD 21204-6831
Phone (443) 849-2484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C0001446MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Baltimore Medical Center, Inc. Past Accepting new patients
Shady Grove Fertility Reproductive Science Center Past Accepting new patients
Shady Grove Reproductive Science Center PC Past Accepting new patients

Organizations & group practices 3

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": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1407056781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6569 N CHARLES ST",
            "address_2": "PPW # 406",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046831",
            "telephone_number": "443-849-2484",
            "fax_number": "443-849-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15001 SHADY GROVE RD",
            "address_2": "SUITE 310",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506352",
            "telephone_number": "301-340-1188",
            "fax_number": "301-340-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY-ALLEN",
        "first_name": "WENDE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.