Individual provider Active NPI

Audrey Tracey, M.D.

  • Family Medicine Physician
  • Leominster, MA
National Provider Identifier
1558329433
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
152307 Issued in MA
Practice address
87 North Main Street
Leominster, MA 01453
Phone
(798) 534-8701
Fax
(978) 534-8705
NPI assigned
May 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 152307 MA Primary

Addresses

Primary practice location

87 North Main Street
Leominster, MA 01453

Mailing address

87 North Main Street
Leominster, MA 01453
Phone (978) 534-8701

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000971 MA Practitioner - Family Practice 5991749848 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Medical and Maternity Care PCGroup PAC ID 6901840859, 14 clinicians

Practice addresses (Care Compare)

87 N Main St
Leominster, MA 01453-5507
Phone (978) 534-8701

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
152307MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical & Maternity Care PC Family Medicine CurrentSince Jun 25, 2002 Accepting new patients

Locations

87 N Main St
Leominster, MA 01453
Phone (800) 688-6663

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAJFCA
  • Direct secure messaging: audrey.tracey@fmmc.eclinicaldirectplus.com

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.

Hospital & facility affiliations 8

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1558329433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 NORTH MAIN STREET",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-8701",
            "fax_number": "978-534-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 NORTH MAIN STREET",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "798-534-8701",
            "fax_number": "978-534-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "AUDREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "152307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.