Tracey Simmons, FNP-BC – Family Medicine Physician

Key facts

NPI: 1578088985
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 53377 (NM)
Practice address: 6349 U.S. Highway 550
Cuba, NM 87013
Phone: (575) 289-3291
NPI assigned: Aug 7, 2017
Sex: Female
Sole proprietor: Yes

Organizations & group practices 5

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.

Presbyterian Medical Services Federally Qualified Health Center (FQHC) · Rio Rancho, NM · NPI 1871505032

Medicare reassignment NPD NM · SINGLE SPECIALTY
Metro Treatment of New Mexico LP Methadone Clinic · Albuquerque, NM · NPI 1710512199

NPD
Presbyterian Medical Services Community/Retail Pharmacy · Albuquerque, NM · NPI 1306654462

NPD
Presbyterian Medical Services Federally Qualified Health Center (FQHC) · Rio Rancho, NM · NPI 1477975688

NPD
Darryl Champion Radiologic Technologist · Lebanon, TN · NPI 1588970990

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NM
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20181031002070	NM	Practitioner - Nurse Practitioner	7719239383	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

State licenses

License	State	Type	Specialty
APN0000022126	TN	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Presbyterian Medical Services	Single Specialty	Current	Accepting new patients
Metro Treatment of New Mexico LP		Current since Nov 27, 2023	Accepting new patients
Presbyterian Medical Services		Current since Sep 10, 2018	Accepting new patients
Presbyterian Medical Services		Current since Sep 10, 2018	Accepting new patients
Darryl Champion		Past since Mar 18, 2018	Accepting new patients

Locations

630 Haines Ave NW
Albuquerque, NM 87102
Phone (505) 268-5611

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LF0000X	APN0000022126	TN
Family Medicine Physician	207Q00000X	53377	NM	Yes

Addresses

Primary practice location

6349 U.S. Highway 550
Cuba, NM 87013

Mailing address

6351 Hwy 550
Apt B
Cuba, NM 87013

Other practice location 1

474 Radnor St
Nashville, TN 37211-2331
Phone (615) 521-4090

Other providers in Cuba, NM

Richard Kozoll, MD, Los Pinos Family Health
Jared Eustaquio Salas, DDS
Karolyn Jean Schaefer, RN
David Earl Schlottman, DDS
Michelle Seebinger, RDH
Helen Louisa Snyder, CRNP CNM
Aurelia Louise Staley, CFNP
Temple Legacy Counseling Services LLC
James Allan Thurmond, D.D.S.
Ruben J. Torrez, MD

All providers in Cuba, NM · Family Medicine Physician in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.