Active NPI
Andrea Tracy, MD
- Pediatrics Physician
- Brunswick, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD12917
- Practice address
- 74 Baribeau Dr
Brunswick, ME 04011-3218 - Phone
- (207) 798-4050
- Fax
- (207) 798-4018
- NPI assigned
- Aug 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD12917 | ME | Primary |
Addresses
Primary practice location
74 Baribeau Dr
Brunswick, ME 04011-3218
Mailing address
PO Box 9746
Portland, ME 04104-5040
Phone (207) 791-3888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 285990099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD12917 | ME | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin'S Point Health Care, Inc. | Pediatrics | Current | Accepting new patients |
Locations
68 Graham St
Biddeford, ME 04005
Phone (207) 283-1441
74 Baribeau Dr
Brunswick, ME 04011
Phone (207) 798-4050
174 S Freeport Rd
Freeport, ME 04032
Phone (207) 865-1819
510 Main St
Gorham, ME 04038
Phone (207) 216-2118
6 Farley Rd
Mere Point, ME 04011
Phone (207) 725-8079
331 Veranda St
Portland, ME 04103
Phone (207) 774-5801
Interoperability endpoints
- https://api.platform.athenahealth.com/5857/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344470400000",
"number": "1679583447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9746",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041045040",
"telephone_number": "207-791-3888",
"fax_number": "207-828-7850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 BARIBEAU DR",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040113218",
"telephone_number": "207-798-4050",
"fax_number": "207-798-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "ANDREA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2012-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ME",
"license": "MD12917",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "285990099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.