Individual provider Active NPI

Tracy Ann Dave, DNP, APRN, FNP-BC

  • Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1417326513
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP 9325635 Issued in FL
Practice address
3000 Hunters Creek Blvd
Orlando, FL 32837-6901
Phone
(407) 857-2502
Fax
(407) 857-1855
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP 9325635 FL Primary

Addresses

Primary practice location

3000 Hunters Creek Blvd
Orlando, FL 32837-6901

Mailing address

3000 Hunters Creek Blvd
Orlando, FL 32837-6901
Phone (407) 857-2502

Other practice location 1

1188 Commerce Park Dr Ste 3001
Altamonte Springs, FL 32714-2091
Phone (407) 857-2502 ext. 1700

Other practice location 2

630 Main St
Altamonte Springs, FL 32701-6413
Phone (407) 857-2502 ext. 1800

Other names 1

  • Tracy Ann Hassad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9325635FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Woman Care, LLC Past Accepting new patients
Womencare PA Past Accepting new patients

Organizations & group practices 2

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": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1417326513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 HUNTERS CREEK BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376901",
            "telephone_number": "407-857-2502",
            "fax_number": "407-857-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 HUNTERS CREEK BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328376901",
            "telephone_number": "407-857-2502",
            "fax_number": "407-857-1855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1188 Commerce Park Dr Ste 3001",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327142091",
            "country_code": "US",
            "telephone_number": "407-857-2502 x1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "630 Main St",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327016413",
            "country_code": "US",
            "telephone_number": "407-857-2502 x1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVE",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "DNP, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP 9325635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "HASSAD",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.