Individual provider Active NPI

Tracy Maria, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1558092791
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
355193 Issued in NY
Practice address
489 5TH Ave FL 3
New York, NY 10017-6145
Phone
(888) 663-6331
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 355193 NY Primary

Addresses

Primary practice location

489 5TH Ave FL 3
New York, NY 10017-6145

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221123002320 NC Practitioner - Nurse Practitioner 9032587969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

724 S Horner Blvd
Sanford, NC 27330-4822
Phone (919) 776-6767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5016395NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Urgent Care and Family Care of WNC, PLLC CurrentSince Dec 5, 2023 Accepting new patients
Fastmed P.C. CurrentSince Nov 24, 2024 Accepting new patients
Dynamic Health Medical Group PLLC PastSince Aug 15, 2018 Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Locations

10102 Johnston Rd
Charlotte, NC 28210
Phone (704) 247-6578

7010 NC Highway 751
Durham, NC 27707
Phone (919) 313-3900

724 S Horner Blvd
Sanford, NC 27330
Phone (919) 776-6767

210 Turnersburg Hwy
#C
Statesville, NC 28625
Phone (704) 924-4740

1025 Peerless Xing NW
Cleveland, TN 37312
Phone (423) 476-5990

Organizations & group practices 4

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": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1558092791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176145",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIA",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "355193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.