Tracy J. McDonald

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209009729 Issued in IL

Practice address

3707 Doty Rd Ste a
Woodstock, IL 60098-7530

Phone

(815) 334-5018

Fax

(815) 206-2822

NPI assigned

Jul 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, OR2 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

Merit-based Incentive Payment System (MIPS)

Final score

95.63 of 100Reported as apm

Quality

88.47

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tmcdonald163914@direct.ochin.org

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.

• Deschutes County Oregon

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bend, OR
  • NPI 1235172180
  Medicare reassignment NPD
• Deschutes County Oregon

  • Addiction (Substance Use Disorder) Counselor
  • Bend, OR
  • NPI 1366656068
  NPD
• Deschutes County Oregon

  • Health Educator
  • Bend, OR
  • NPI 1598323040
  NPD

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1417212150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 DOTY RD STE A",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987530",
            "telephone_number": "815-334-5018",
            "fax_number": "815-206-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 DOTY RD STE A",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987530",
            "telephone_number": "815-334-5018",
            "fax_number": "815-206-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2577 NE Courtney Dr",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977017638",
            "country_code": "US",
            "telephone_number": "541-322-7500",
            "fax_number": "541-322-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "TRACY",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "IL",
            "license": "041370037",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201500684NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathers Community Mental Health Center LLC
• Mathew Clinical Services
• Kimberly Mathew, PSY.D
• Christopher Thomas McCarthy, LPC
• Richard Lee McCoy, MA, NCC, LCPC
• Katherine A McGranahan
• McHenry Co. Latino Coalition
• McHenry County Department of Health
• McHenry County Department of Health
• McHenry County Mental Health Board

• Nurse Practitioner in Woodstock, IL
• Providers in Woodstock, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.