Individual provider Active NPI

Tracey Simmons, FNP-BC

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1578088985
Registry record updated Oct 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
53377 Issued in NM
Practice address
10221 Central Ave NE
Albuquerque, NM 87123-2733
Phone
(505) 206-5630
NPI assigned
Aug 7, 2017
Last updated
Oct 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X APN0000022126 TN
Family Medicine Physician 207Q00000X 53377 NM Primary

Addresses

Primary practice location

10221 Central Ave NE
Albuquerque, NM 87123-2733

Mailing address

6351 Hwy 550
Apt B
Cuba, NM 87013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20181031002070 NM Practitioner - Nurse Practitioner 7719239383 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53377NMMDFamily Medicine Physician
APN0000022126TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Treatment of New Mexico LP CurrentSince Nov 27, 2023 Accepting new patients
Presbyterian Medical Services CurrentSince Sep 10, 2018 Accepting new patients
Presbyterian Medical Services CurrentSince Sep 10, 2018 Accepting new patients
Presbyterian Medical Services Single Specialty Current Accepting new patients
Darryl Champion PastSince 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791849600000",
    "number": "1578088985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 HWY 550",
            "address_2": "APT B",
            "city": "CUBA",
            "state": "NM",
            "postal_code": "87013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10221 CENTRAL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232733",
            "telephone_number": "505-206-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TRACEY",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2026-10-13",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000022126",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "53377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.