Individual provider Active NPI

Tracy A Hooper, PT

  • Physical Therapist
  • Mystic, CT
National Provider Identifier
1750685541
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008911 Issued in CT
Practice address
2440 Gold Star Hwy
Suite 201
Mystic, CT 06355-1180
Phone
(860) 536-1001
Fax
(860) 536-1527
NPI assigned
Jan 7, 2011
Last updated
Dec 19, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008911 CT Primary

Addresses

Primary practice location

2440 Gold Star Hwy
Suite 201
Mystic, CT 06355-1180

Mailing address

2440 Gold Star Hwy
Suite 201
Mystic, CT 06355-1180
Phone (860) 536-1001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110329000111 CT Practitioner - Physical Therapist in Private Practice 4284817214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Physical Therapy, LLCGroup PAC ID 6608808274, 12 clinicians

Practice addresses (Care Compare)

2440 Gold Star Hwy
Mystic, CT 06355-1180

2440 Gold Star Hwy 201
Mystic, CT 06355-1180
Phone (860) 536-1001

2440 Goldstar Hwy
Suite 201
Mystic, CT 06355-1180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8911CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Physical Therapy, LLC Physical Therapist CurrentSince Jan 10, 2011 Accepting new patients

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, 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": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1750685541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 GOLD STAR HWY",
            "address_2": "SUITE 201",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551180",
            "telephone_number": "860-536-1001",
            "fax_number": "860-536-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 GOLD STAR HWY",
            "address_2": "SUITE 201",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063551180",
            "telephone_number": "860-536-1001",
            "fax_number": "860-536-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOPER",
        "first_name": "TRACY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mystic, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.