NPIMap

Individual provider Active NPI

Tracy L Haley, MD

  • Surgery Physician
  • Medford, OR
National Provider Identifier
1407943889
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD24518 Issued in OR
Practice address
1698 E McAndrews Rd
Suite 160
Medford, OR 97504-5589
Phone
(541) 732-7874
Fax
(541) 732-7875
NPI assigned
Oct 6, 2006
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD24518 OR Primary

Addresses

Primary practice location

1698 E McAndrews Rd
Suite 160
Medford, OR 97504-5589

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (541) 732-7874

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thaley139787@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20050105000318 OR Practitioner - General Surgery 1850349010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of California, Davis School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1111 Crater Lake Ave
Medford, OR 97504-6241
Phone (541) 732-5545

1698 E McAndrews Rd
Medford, OR 97504-5590

940 Royal Ave
Medford, OR 97504-6194

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Mastectomy39
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2005 Accepting new patients
Providence Health & Services - Oregon CurrentSince Mar 31, 2019 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2005 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

935 Siskiyou Blvd
Ashland, OR 97520
Phone (541) 482-2716

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

1698 E McAndrews Rd
Ste 100
Medford, OR 97504
Phone (541) 858-2565

1698 E McAndrews Rd
Ste 160
Medford, OR 97504
Phone (541) 732-6070

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

940 Royal Ave
Unit 450
Medford, OR 97504
Phone (541) 732-7850

Interoperability endpoints

  • Direct secure messaging: thaley139787@oc.providencedirect.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1407943889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-732-7874",
            "fax_number": "541-732-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1698 E MCANDREWS RD",
            "address_2": "SUITE 160",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975045589",
            "telephone_number": "541-732-7874",
            "fax_number": "541-732-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "TRACY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OR",
            "license": "MD24518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thaley139787@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1698 E McAndrews Rd",
            "address_2": "Suite 160",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975045589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.