Individual provider Active NPI

Tracy Wissell, RN-BC, NP-C

  • Family Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1770982639
Registry record updated Aug 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20NJ00514500 Issued in NJ
Practice address
92 2ND St
Hackensack, NJ 07601-2191
Phone
(551) 996-5900
NPI assigned
Aug 17, 2014
Last updated
Aug 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20NJ00514500 NJ Primary

Addresses

Primary practice location

92 2ND St
Hackensack, NJ 07601-2191

Mailing address

692 Oak Ave
Maywood, NJ 07607-1514
Phone (201) 712-0043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170530002500 NJ Practitioner - Nurse Practitioner 1951678606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.1 of 100Reported as subgroup
Quality
51.56
Promoting interoperability
100
Improvement activities
40
Cost
70.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20NJ00514500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Apr 9, 2017 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Apr 9, 2017 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

Organizations & group practices 2

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": "1408233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408233600000",
    "number": "1770982639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "692 OAK AVE",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071514",
            "telephone_number": "201-712-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSELL",
        "first_name": "TRACY",
        "name_prefix": "Ms.",
        "credential": "RN-BC, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-17",
        "last_updated": "2014-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "20NJ00514500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.