NPIMap

Individual provider Active NPI

Tracy Van-Ness, P.A.

  • Physician Assistant
  • Stony Brook, NY
National Provider Identifier
1750319489
Registry record updated Jun 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007604 Issued in NY
Practice address
New York Spine and Brain Surgery
HSC T12 RM 080
Stony Brook, NY 11794-8122
Phone
(631) 444-1116
Fax
(631) 444-1535
NPI assigned
Jun 29, 2006
Last updated
Jun 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 007604 NY Primary

Addresses

Primary practice location

New York Spine and Brain Surgery
HSC T12 RM 080
Stony Brook, NY 11794-8122

Mailing address

HSC T12 RM 080
Stony Brook, NY 11794-8122
Phone (631) 444-1116

Other identifiers 1

IdentifierTypeStateIssuer
02669583MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050208000450 NY Practitioner - Physician Assistant 7618928540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

101 Nicolls Rd
Stony Brook, NY 11794-8122
Phone (631) 444-1213

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Long Island Jewish Healthcare Inc. CurrentSince Aug 1, 2006 Accepting new patients
New York Spine and Brain Surgery Past Accepting new patients

Networks

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

Interoperability endpoints

  • Direct secure messaging: tracy.vanness@direct.stonybrookmedicine.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402444800000",
    "number": "1750319489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEW YORK SPINE AND BRAIN SURGERY",
            "address_2": "HSC T12 RM 080",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948122",
            "telephone_number": "631-444-1116",
            "fax_number": "631-444-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN-NESS",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02669583",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.