Tracey Lynn Messina, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

F38330501 Issued in NY

Practice address

112 Cedar Ave
Patchogue, NY 11772-3538

Phone

(631) 252-2047

NPI assigned

Mar 1, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989

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.

• Stony Brook Surgical Associates, University Faculty Practice Corporati

  • Surgery Physician
  • Stony Brook, NY
  • NPI 1063468536
  Medicare reassignment NPD
• Stony Brook Anaesthesiology, University Faculty Practice Corporation

  • Anesthesiology Physician
  • Stony Brook, NY
  • NPI 1801841184
  NPD (past)
• Stony Brook Children's Service, University Faculty Practice Corporatio

  • Pediatrics Physician
  • Stony Brook, NY
  • NPI 1083660575
  NPD (past)

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1548916414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CEDAR AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723538",
            "telephone_number": "631-252-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 CEDAR AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723538",
            "telephone_number": "631-252-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINA",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F38330501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUNY EDUCATION DEPARTMENT OFFICE OF PROFESSIONS",
            "identifier": "661462-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina A Melli, DPT
• Kim Keziah Mendez, ANP-C
• Dianna Mendoza
• Anthony Messina, RN, BSN
• Jessica Messina
• Metro Therapy
• Stephanie Rachel Mewhinney, LCSW
• Rubab Mian, D.O.
• Nicholas Miceli, D.C.
• Michelle Doxsee PT PC

• Pediatric Nurse Practitioner in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.