Individual provider Active NPI

Tracy Edwards, NP

  • Nurse Practitioner
  • Portland, ME
National Provider Identifier
1700865912
Registry record updated Dec 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP081420 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 706-3280
NPI assigned
Jan 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP081420 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280

Other identifiers 1

IdentifierTypeStateIssuer
260520099MedicaidME

Other names 1

  • Tracy Creaser Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051103001002 ME Practitioner - Nurse Practitioner 6406874890 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

  • Mainehealth Pen Bay Hospital Hospital, Rockport, ME, CCN 200063
  • Mainehealth Franklin Hospital Hospital, Farmington, ME, CCN 201316
  • Central Maine Medical Center Hospital, Lewiston, ME, CCN 200024
  • Mainehealth Stephens Hospital Hospital, Norway, ME, CCN 201315

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP081420MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Maine Medical Center CurrentSince Jan 1, 1998 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Jan 6, 2025 Accepting new patients
Central Maine Medical Center CurrentSince Jan 1, 1998 Accepting new patients
Mainehealth CurrentSince Jan 6, 2025 Accepting new patients

Locations

12 High St
Ste 300
Lewiston, ME 04240
Phone (207) 795-5700

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

12 High St
Ste 302
Lewiston, ME 04240
Phone (207) 795-5730

364 Main St
Lewiston, ME 04240
Phone (207) 795-5646

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/
  • Direct secure messaging: tedwards891735@direct.mmc.mainehealth.org

Organizations & group practices 5

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 4

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": "1137369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1700865912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-706-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-706-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "TRACY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-16",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "AP081420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260520099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "CREASER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.