Mahkameh Ghadimi Tracy, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DR.0050393 Issued in CO

Practice address

4318 Trail Boss Dr Ste 100
Castle Rock, CO 80104-7512

Phone

(303) 338-4545

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mahkameh Ghadimi Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Family Practice

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mednow Clinics, IncGroup PAC ID 0042533242, 56 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14209/brand/2/csg/1/fhir/r4
• Direct secure messaging: mahkameh.tracy.1@14209.direct.athenahealth.com

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.

• Mednow Clinics, Inc

  • Primary Care Clinic/Center
  • Aurora, CO
  • NPI 1669888764
  Medicare reassignment Care Compare group NPD
• Mednow Clinics, Inc.

  • Family Medicine Physician
  • Centennial, CO
  • NPI 1043901630
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1669634739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 TRAIL BOSS DR STE 100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801047512",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "MAHKAMEH",
        "middle_name": "GHADIMI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "CO",
            "license": "DR.0050393",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0050393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58422757",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAIASER COMMERCIAL NUMBER",
            "identifier": "029172",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4318 Trail Boss Dr Ste 100",
            "city": "Castle Rock",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801047512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MAHKAMEH",
            "last_name": "GHADIMI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ezekeal Torrez
• Total Renal Care Inc
• Town of Castle Rock
• Carolina Townsend
• Michael Keyes Townsend, D.D.S.
• Angela T Tran, D.O.
• Bethanie Lan Ngoc Tran, PHARM.D
• Lyn Tran
• Travel Paradise Vacations
• Travel Paradise Vacations

• Family Medicine Physician in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.