NPIMap

Individual provider Active NPI

Tracy D Ray, PA-C

  • Physician Assistant
  • Sidney, NE
National Provider Identifier
1447388608
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1095 Issued in NE
Practice address
645 Osage Street
Sidney Regional Medical Center
Sidney, NE 69162-1714
Phone
(308) 254-5825
Fax
(308) 254-7258
NPI assigned
Mar 1, 2007
Last updated
Dec 1, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 733 AK
Physician Assistant 363A00000X 1095 NE Primary
Physician Assistant 363A00000X 15-01049 KS
Physician Assistant 363A00000X 1870 IA

Addresses

Primary practice location

645 Osage Street
Sidney Regional Medical Center
Sidney, NE 69162-1714

Mailing address

645 Osage Street
Sidney, NE 69162-1714
Phone (308) 254-5825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041108000335 NE Practitioner - Physician Assistant 3779546114 Reassigns benefits to 8 organizations
I20080604000657 IA Practitioner - Physician Assistant 3779546114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ringgold County HospitalGroup PAC ID 7315849973, shared by 4 NPIs, 32 clinicians
Cherry County HospitalGroup PAC ID 5698686012, 24 clinicians

Practice addresses (Care Compare)

504 N Cleveland St
Mount Ayr, IA 50854-2201
Phone (641) 464-3226

510 N Green St
Valentine, NE 69201-1932
Phone (402) 376-2525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1095NEMDSpeech-Language Pathologist
733AKMDPhysician Assistant
1870IAMDPhysician Assistant
15-01049KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry County Hospital Current Accepting new patients
Alegent Creighton Clinic CurrentSince Jan 1, 2025 Accepting new patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Jan 1, 2026 Accepting new patients
St. Mary's Community Hospital Current Accepting new patients
Jennie M Melham Memorial Medical Center Inc CurrentSince Jan 1, 2026 Accepting new patients
The Physician Network PastSince Sep 1, 2011 Accepting new patients
Cozad Community Hospital Past Accepting new patients

Locations

510 N Green St
Valentine, NE 69201
Phone (402) 376-3770

Interoperability endpoints

  • Direct secure messaging: tray@bbgh.securechart.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1447388608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 OSAGE STREET",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691621714",
            "telephone_number": "308-254-5825",
            "fax_number": "308-254-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 OSAGE STREET",
            "address_2": "SIDNEY REGIONAL MEDICAL CENTER",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691621714",
            "telephone_number": "308-254-5825",
            "fax_number": "308-254-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "TRACY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "733",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "1095",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01049",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "1870",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, NE

Sources for this page

Verify at the official NPI Registry.