Individual provider Active NPI

Tracey Ann C Mitchell, CRNP

  • Acute Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1619160116
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP015853 Issued in PA
Practice address
800 Spruce St
1 Pine West
Philadelphia, PA 19107-6130
Phone
(215) 829-7817
Fax
(215) 829-7129
NPI assigned
Aug 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP008871 PA
Acute Care Nurse Practitioner 363LA2100X SP015853 PA Primary

Addresses

Primary practice location

800 Spruce St
1 Pine West
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Pine 1 East
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070910000481 PA Practitioner - Nurse Practitioner 8820181647 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Spruce St FL 1 Pine W
Hospital Medicine Pah
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP015853PAMDAcute Care Nurse Practitioner
SP008871PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health Current Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Jun 9, 2009 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 28, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Jun 28, 2021 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst CurrentSince Jun 9, 2009 Accepting new patients

Locations

800 Spruce St
Fl 1
Philadelphia, PA 19107
Phone (215) 829-5873

800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817

230 W Washington Sq
Bldg 2ND
Philadelphia, PA 19106
Phone (215) 829-6088

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

800 Spruce St
#1
William Penn Annex West, PA 19107
Phone (215) 829-2222

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

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.

Hospital & facility affiliations 1

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": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1619160116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "PINE 1 EAST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "address_2": "1 PINE WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "TRACEY ANN",
        "middle_name": "C",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP008871",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP015853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.