Individual provider Active NPI

Tracy Alexander, D.O.

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1770777161
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
05-33527 Issued in KS
Practice address
2496 Bauer Rd
San Diego, CA 92145-0001
Phone
(619) 788-1653
NPI assigned
Aug 29, 2007
Last updated
Sep 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 05-33527 KS Primary
Family Medicine Physician 207Q00000X 14878 CA

Addresses

Primary practice location

2496 Bauer Rd
San Diego, CA 92145-0001

Mailing address

2496 Bauer Rd
San Diego, CA 92145-0001
Phone (619) 532-8225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20210727003765 KS Practitioner - Family Practice 4789970468 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14878CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gracemed Health Clinic, Inc CurrentSince Aug 9, 2021 Accepting new patients
Gracemed Health Clinic Inc CurrentSince Aug 9, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1122 N Topeka St
Wichita, KS 67214
Phone (316) 263-7455

1150 N Broadway Ave
Wichita, KS 67214

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.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1770777161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 BAUER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921450001",
            "telephone_number": "619-532-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2496 BAUER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921450001",
            "telephone_number": "619-788-1653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "TRACY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-33527",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "14878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.