NPIMap

Individual provider Active NPI

Traci L Tyger, PA-C

  • Physician Assistant
  • Du Bois, PA
National Provider Identifier
1619971108
Registry record updated Jun 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA003210L Issued in PA
Practice address
100 Hospital Ave
Hahne Regional Cancer Center/Radiation Oncology
Du Bois, PA 15801-1440
Phone
(814) 375-3535
Fax
(814) 375-3529
NPI assigned
Jun 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA003210L PA Primary

Addresses

Primary practice location

100 Hospital Ave
Hahne Regional Cancer Center/Radiation Oncology
Du Bois, PA 15801-1440

Mailing address

PO Box 447
Du Bois, PA 15801-0447
Phone (814) 375-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000223 PA Practitioner - Physician Assistant 6305825811 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, shared by 39 NPIs, 424 clinicians

Practice addresses (Care Compare)

100 Hospital Ave
Du Bois, PA 15801-1440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA003210LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Jul 1, 2009 Accepting new patients
Dubois Regional Medical Group, PC Physician Assistant CurrentSince Oct 1, 2020 Accepting new patients
Dubois Regional Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Dubois Regional Medical Center CurrentSince Jul 1, 2009 Accepting new patients
Dubois Regional Medical Center Physician Assistant CurrentSince Jul 1, 2009 Accepting new patients
Chambers Family Health PC Past Accepting new patients
Dubois Regional Medical Center Physician Assistant Past Accepting new patients

Locations

298 Main St
Brookville, PA 15825
Phone (814) 849-5288

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

145 Hospital Ave
Ste 102
Dubois, PA 15801
Phone (814) 375-6510

Organizations & group practices 8

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 33

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308787200000",
    "number": "1619971108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 447",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158010447",
            "telephone_number": "814-375-3535",
            "fax_number": "814-375-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL AVE",
            "address_2": "HAHNE REGIONAL CANCER CENTER/RADIATION ONCOLOGY",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011440",
            "telephone_number": "814-375-3535",
            "fax_number": "814-375-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYGER",
        "first_name": "TRACI",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2011-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA003210L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

Verify at the official NPI Registry.