Individual provider Active NPI

Tracey Lynn McIntyre, DC

  • Chiropractor
  • Pearland, TX
National Provider Identifier
1437211695
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9989 Issued in TX
Practice address
1819 Broadway St
Suite 101
Pearland, TX 77581-5670
Phone
(281) 993-9333
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9989 TX Primary

Addresses

Primary practice location

1819 Broadway St
Suite 101
Pearland, TX 77581-5670

Mailing address

1819 Broadway St
Suite 101
Pearland, TX 77581-5670
Phone (281) 993-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050909000689 TX Practitioner - Chiropractic 8729010749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1819 Broadway St
Suite 101
Pearland, TX 77581-5671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9989TXMDMarriage & Family Therapist
9983TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Physicians Healthcare PLLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

1819 Broadway St
Ste 10
Pearland, TX 77581

1819 Broadway St
Ste 101
Pearland, TX 77581
Phone (281) 993-2003

1819 Broadway St
Ste AND102
Pearland, TX 77581

1819 Broadway St
Pearland, TX 77581

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1437211695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815670",
            "telephone_number": "281-993-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BROADWAY ST",
            "address_2": "SUITE 101",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815670",
            "telephone_number": "281-993-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.