Tracy M Bennett, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1097 Issued in ME

Practice address

360 Broadway
Bangor, ME 04401-3900

Phone

(207) 907-3650

Fax

(207) 907-3660

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME

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 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Joseph HospitalGroup PAC ID 6406766336, 197 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Merit-based Incentive Payment System (MIPS)

Final score

96.58 of 100Reported as apm

Quality

83.17

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Medicare reassignment Care Compare group
• St. Joseph Ambulatory Care Inc

  • Medical Specialty Clinic/Center
  • Bangor, ME
  • NPI 1184678088
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Joseph Hospital

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1154321545
  Care Compare affiliation

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1457560419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/OST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8560",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013900",
            "telephone_number": "207-907-3650",
            "fax_number": "207-907-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "TRACY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbennett613646@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bobbie Benjamin, LMSW-CC
• Katrina H Benjamin, LCSW
• Marian Benner, MD
• Lindsay Bennett, M.A., CCC-SLP
• Mark Allen Bennett, LCPC-C
• Joseph Lawrence Benoit, MD
• Paul Richard Benoit Jr., M.D.
• Elisha Marie Benson, LCSW
• Rachel Robinson Benson, LCSW
• Morgan Frances Benter, PA-C

• Physician Assistant in Bangor, ME
• Providers in Bangor, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.