Individual provider Active NPI

Tracey K Peatross, M.D.

  • Obstetrics & Gynecology Physician
  • Yuma, AZ
National Provider Identifier
1730166349
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
38225 Issued in AZ
Practice address
2400 S Avenue a
Yuma, AZ 85364-7170
Phone
(928) 344-2000
NPI assigned
Dec 23, 2005
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 38225 AZ Primary

Addresses

Primary practice location

2400 S Avenue a
Yuma, AZ 85364-7170

Mailing address

1530 E Williams Field Rd Ste 201
Gilbert, AZ 85295-1825
Phone (480) 914-0013

Other identifiers 1

IdentifierTypeStateIssuer
361562MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20090302000616 AZ Practitioner - Obstetrics/Gynecology 0244219772 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Practice addresses (Care Compare)

2400 S Ave a
Yuma, AZ 85364-7127
Phone (928) 344-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38225AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. CurrentSince Feb 5, 2024 Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Feb 5, 2024 Accepting new patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients
Yuma Regional Medical Center CurrentSince Jul 30, 2023 Accepting new patients
San Luis Walk-in Clinic, Inc. PastSince May 17, 2020 Accepting new patients
Albert T. Domingo Ms MD Inc PastSince Aug 10, 1990 Accepting new patients
Meridia Medical Group, LLC Past Accepting new patients
Uhhs Bedford Past Accepting new patients

Locations

601 W Riverside Dr
Ste 4
Parker, AZ 85344
Phone (928) 256-4110

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: tpeatross673213@hisp.ehr.sutterhealth.org

Organizations & group practices 8

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1730166349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 E WILLIAMS FIELD RD STE 201",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951825",
            "telephone_number": "480-914-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647170",
            "telephone_number": "928-344-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATROSS",
        "first_name": "TRACEY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "38225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361562",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.