Individual provider Active NPI

James Tracy, D.O.

  • Allergy & Immunology Physician
  • Plantation, FL
National Provider Identifier
1639303852
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
UO4175 Issued in FL
Practice address
817 S University Dr
#106
Plantation, FL 33324-3309
Phone
(954) 723-0334
Fax
(954) 723-0807
NPI assigned
May 4, 2009
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Allergy & Immunology Physician 207K00000X UO4175 FL Primary

Addresses

Primary practice location

817 S University Dr
#106
Plantation, FL 33324-3309

Mailing address

1750 Thompson Rd
#106
Coos Bay, OR 97420-2100
Phone (541) 269-0333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207001675 OR Practitioner - Allergy/Immunology 4981848215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bay ClinicGroup PAC ID 9638164874, 13 clinicians

Practice addresses (Care Compare)

1750 Thompson Rd
Coos Bay, OR 97420-2100
Phone (541) 269-0333

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO4175FLMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Bend Medical Center Inc CurrentSince Feb 1, 2019 Accepting new patients
North Bend Medical Center Inc CurrentSince Feb 1, 2019 Accepting new patients
Bay Clinic CurrentSince Jan 1, 2017 Accepting new patients

Locations

1750 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-0333

1750 Thompson Rd
#106
Coos Bay, OR 97420

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/bea62b1d-5b0c-4c1a-bdbd-eaa129312421/
  • Direct secure messaging: jtracy125110@secure.stcharleshealthcare.org

Organizations & group practices 3

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 3

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": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1639303852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 THOMPSON RD",
            "address_2": "#106",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202100",
            "telephone_number": "541-269-0333",
            "fax_number": "541-267-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S UNIVERSITY DR",
            "address_2": "#106",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243309",
            "telephone_number": "954-723-0334",
            "fax_number": "954-723-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-04",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "UO4175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.