Individual provider Active NPI

Tracy Ann Casas, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Palos Heights, IL
National Provider Identifier
1760904676
Registry record updated Jul 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209016060 Issued in IL
Practice address
12251 S 80TH Ave
Palos Heights, IL 60463-1256
Phone
(708) 923-4000
NPI assigned
Jul 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041378617 IL
Acute Care Nurse Practitioner 363LA2100X 209016060 IL Primary

Addresses

Primary practice location

12251 S 80TH Ave
Palos Heights, IL 60463-1256

Mailing address

22390 Aster Dr
Frankfort, IL 60423-7897
Phone (815) 919-2071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211216002130 FL Practitioner - Nurse Practitioner 9638443906 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041378617ILMDRegistered Nurse
209016060ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hematology Oncology LLC CurrentSince Jun 1, 2024 Accepting new patients
Tampa General Medical Group Inc CurrentSince Feb 1, 2022 Accepting new patients
Comprehensive Hematology Oncology LLC CurrentSince Jun 1, 2024 Accepting new patients
Tampa General Medical Group Inc CurrentSince Feb 1, 2022 Accepting new patients

Locations

3501 Cortez Rd W
Bradenton, FL 34210
Phone (941) 752-2700

214 Morrison Rd
Ste 110
Brandon, FL 33511
Phone (800) 844-9302

1835 Indian Rocks Rd S
Largo, FL 33774
Phone (727) 586-2273

5000 Park St N
Ste 1017
St Petersburg, FL 33709
Phone (727) 344-6570

2 Tampa General Cir
Fl 3
Tampa, FL 33606
Phone (813) 259-0600

3611 Little Rd
Trinity, FL 34655
Phone (727) 312-4300

Networks

  • Freedom Health HMO Network

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499817600000",
    "number": "1760904676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22390 ASTER DR",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604237897",
            "telephone_number": "815-919-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASAS",
        "first_name": "TRACY",
        "middle_name": "ANN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-12",
        "last_updated": "2017-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041378617",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209016060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.