Individual provider Active NPI

Tracey N Hopper

  • Surgical Physician Assistant
  • Spokane, WA
National Provider Identifier
1720472491
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60701011 Issued in WA
Practice address
217 W Cataldo Ave FL 3
Spokane, WA 99201-2217
Phone
(509) 747-6194
NPI assigned
Mar 20, 2015
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA60701011 WA
Surgical Physician Assistant 363AS0400X PA60701011 WA Primary

Addresses

Primary practice location

217 W Cataldo Ave FL 3
Spokane, WA 99201-2217

Mailing address

PO Box 421
Liberty Lake, WA 99019-0421

Other practice location 1

19 N 7th St
Cheney, WA 99004-2220
Phone (509) 838-2531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20170113000412 WA Practitioner - Physician Assistant 8921380684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 E Columbia Ave
Colville, WA 99114-3354
Phone (509) 684-3701

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-0111

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.06
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60701011WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 1, 2024 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 1, 2024 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients
Rockwood Clinic PS Past Accepting new patients

Locations

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

217 W Cataldo Ave
Fl 3
Spokane, WA 99201
Phone (509) 624-2326

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1720472491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "fax_number": "509-227-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W CATALDO AVE FL 3",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-747-6194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Cheney",
            "state": "WA",
            "postal_code": "990042220",
            "country_code": "US",
            "telephone_number": "509-838-2531",
            "fax_number": "509-755-6580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "TRACEY",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60701011",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60701011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.