Tracy Rostholder

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

299069 Issued in NY

Practice address

222 Station PLZ N Ste 611
Mineola, NY 11501-3893

Phone

(516) 663-2532

Fax

(516) 663-4409

NPI assigned

Jun 8, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

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.

• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1639209596
  Medicare reassignment NPD
• University at Buffalo Pediatric Associates Inc

  • Pediatrics Physician
  • Buffalo, NY
  • NPI 1912928599
  Medicare reassignment NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY, Pediatrics

  Medicare reassignment NPD
• Kaleida Health

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1366473183
  NPD
• Kaleida Health

  • Community/Retail Pharmacy
  • Buffalo, NY
  • NPI 1992540546
  NPD
• New York University

  • Physical Medicine & Rehabilitation Physician
  • Boynton Beach, FL
  • NPI 1104787613
  NPD

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1669821732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893",
            "telephone_number": "516-663-2532",
            "fax_number": "516-663-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 611",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893",
            "telephone_number": "516-663-2532",
            "fax_number": "516-663-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTHOLDER",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "299069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trostholder243107@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "222 Station Plz N Ste 611",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115013893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barry Mark Rosenthal, MD
• Mary Ann Rosman, D.C.
• Ross Orthopedic Group PC
• Bruce R Ross, MD
• Hank Ross, MD
• Gary D Rothberger, MD
• Elissa Hope Rubin, MD
• Stuart Samuel Rubin
• Thomas Anthony Rubin, MD
• Donna Marie Rubino, M.A. CCC

• Pediatrics Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.