Tracy Martin Deselm, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 82001 Issued in FL

Practice address

1 Fletcher Dr.
Gainesville, FL 32611-7500

Phone

(352) 392-1161

NPI assigned

Apr 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Nes of Florida Inc

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1598707689
  NPD (past)
• Piedmont Emergency Medical Associates, PA

  • Emergency Medicine Physician
  • Charlotte, NC
  • NPI 1801822523
  NPD (past)

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1598722902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 SW 115TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326071147",
            "telephone_number": "352-331-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FLETCHER DR.",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326117500",
            "telephone_number": "352-392-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESELM",
        "first_name": "TRACY",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 82001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261353100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tracy_deselm@med.unc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adrienne Desalvo, LMFT
• Pamela Louise Desantis, LMT
• Malissa Descalzo
• Brent Deschaine, MD
• Maria Deschaine, MD
• Meghan Deshais, M.ED., BCBA
• Ronda Lucille Deshields, LCSW
• Shreeya Sudhir Deshmukh
• Ginige Sashinya Nishka Desilva
• Micheline Desir

• Family Medicine Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.