Individual provider Active NPI

Carolyn Tracey, FNP

  • Nurse Practitioner
  • Leominster, MA
National Provider Identifier
1578290540
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2348466 Issued in MA
Practice address
87 N Main St
Leominster, MA 01453-5507
Phone
(978) 534-8701
NPI assigned
Aug 1, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2348466 MA Primary
Registered Nurse 163W00000X RN2348466 MA

Addresses

Primary practice location

87 N Main St
Leominster, MA 01453-5507

Mailing address

554 Brook Rd
Milton, MA 02186-2824
Phone (978) 602-5328

Other practice location 1

554 Brook Rd
Milton, MA 02186-2824
Phone (978) 602-5328

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221118000903 MA Practitioner - Nurse Practitioner 6406224674 Reassigns benefits to 1 organization

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
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

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical & Maternity Care PC CurrentSince Oct 24, 2022 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

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

Hospital & facility affiliations 2

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": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1578290540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 BROOK RD",
            "city": "MILTON",
            "state": "MA",
            "postal_code": "021862824",
            "telephone_number": "978-602-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 N MAIN ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535507",
            "telephone_number": "978-534-8701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 Brook Rd",
            "address_purpose": "LOCATION",
            "city": "Milton",
            "state": "MA",
            "postal_code": "021862824",
            "country_code": "US",
            "telephone_number": "978-602-5328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "CAROLYN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2348466",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2348466",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.