Tracy Lee Pacitti, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ01020300 Issued in NJ

Practice address

280 Middletown Blvd
Langhorne, PA 19047-1816

Phone

(267) 572-3100

NPI assigned

Apr 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Tracy Lee Distefano Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Professional Assist Services Inc.

  • Nursing Care Agency
  • Fairless Hills, PA
  • NPI 1366770562
  NPD
• Kennedy Medical Group Practice P.C.

  • Family Medicine Physician
  • West Deptford, NJ
  • NPI 1952615981
  NPD (past)

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1407076789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STANFORD RD",
            "city": "FAIRLESS HILLS",
            "state": "PA",
            "postal_code": "190304010",
            "telephone_number": "215-949-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MIDDLETOWN BLVD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190471816",
            "telephone_number": "267-572-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACITTI",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01020300",
            "primary": true
        },
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "PA",
            "license": "RN349942L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "DISTEFANO",
            "middle_name": "LEE",
            "prefix": "MRS.",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Oxford Valley Pain and Surgical Center Inc
• Oxford Valley Vein & Laser Center
• Oxygen Oasis Hyperbaric Wellness Center, LLC
• Oxygen Therapurity LLC
• Suzie Vu Pace, DO
• Joseph James Pagano, D.O.
• Ambily Pailo, NP-C
• Pain Care Associates, LLC
• Pain Management Centers of America, LLC
• Daniel Pak

• Family Nurse Practitioner in Langhorne, PA
• Providers in Langhorne, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.