Active NPI
Tracy Lynn Delong, FNP
- Nurse Practitioner
- Costa Mesa, CA
National Provider Identifier
1427772748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95022889
- Practice address
- 275 Victoria St Ste 2K
Costa Mesa, CA 92627-1906 - Phone
- (949) 646-1631
- NPI assigned
- Sep 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 537375 | CA | |
| Nurse Practitioner | 363L00000X | 95022889 | CA | Primary |
Addresses
Primary practice location
275 Victoria St Ste 2K
Costa Mesa, CA 92627-1906
Mailing address
275 Victoria St Ste 2K
Costa Mesa, CA 92627-1906
Phone (949) 646-1631
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://memorialcare.org/fhir/api/FHIR/R4/ | Health Information Exchange (HIE) | MemorialCare Medical Foundation |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 537375 | CA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Nurse Practitioner | Current | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
18102 Culver Dr
Irvine, CA 92612
Phone (657) 241-8220
Organizations & group practices 1
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": "1664409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732752000000",
"number": "1427772748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 VICTORIA ST STE 2K",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-646-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 VICTORIA ST STE 2K",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-646-1631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELONG",
"first_name": "TRACY",
"middle_name": "LYNN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-29",
"last_updated": "2024-11-28",
"certification_date": "2024-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "537375",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95022889",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
"affiliation": "Y",
"endpointDescription": "MemorialCare FHIR Endpoint",
"affiliationName": "MemorialCare Medical Foundation",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "17360 Brookhurst St",
"city": "Fountain Valley",
"state": "CA",
"country_code": "US",
"postal_code": "927083720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.