NPIMap

Individual provider Active NPI

Todd Christian Tracy, MD

  • Internal Medicine Physician
  • Milford, CT
National Provider Identifier
1780769919
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
037452 Issued in CT
Practice address
40 Commerce Park
Milford, CT 06460
Phone
(203) 878-3531
Fax
(203) 876-2169
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 037452 CT Primary

Addresses

Primary practice location

40 Commerce Park
Milford, CT 06460

Mailing address

40 Commerce Park
Milford, CT 06460
Phone (203) 878-3531

Other identifiers 3

IdentifierTypeStateIssuer
01037452OtherCTNMO CIGNA
760889OtherCTHMO CONNECTICARE
1374529MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20100927001053 CT Practitioner - Internal Medicine 9739205873 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine of Milford PCGroup PAC ID 6507834306, 8 clinicians
Rehabilitation Associates IncGroup PAC ID 8022905322, shared by 2 NPIs, 525 clinicians

Practice addresses (Care Compare)

40 Commerce Park
Milford, CT 06460-3535
Phone (203) 878-3531

555 Bridgeport Ave
Shelton, CT 06484-4749
Phone (203) 922-1773

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
037452CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Milford, P.C. Internal Medicine CurrentSince Jul 1, 1999 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

40 Commerce Park
Milford, CT 06460
Phone (203) 878-3531

40 Commerce Park
Ste 1
Milford, CT 06460
Phone (203) 878-3531

Interoperability endpoints

  • Direct secure messaging: todd.tracy@imm.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJBDAA

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.

Hospital & facility affiliations 9

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1780769919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 COMMERCE PARK",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "06460",
            "telephone_number": "203-878-3531",
            "fax_number": "203-876-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 COMMERCE PARK",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "06460",
            "telephone_number": "203-878-3531",
            "fax_number": "203-876-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "TODD",
        "middle_name": "CHRISTIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "037452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NMO CIGNA",
            "identifier": "01037452",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO CONNECTICARE",
            "identifier": "760889",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1374529",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

Verify at the official NPI Registry.