Individual provider Active NPI

Tracy Melancon Fife, NPC

  • Adult Health Nurse Practitioner
  • Marrero, LA
National Provider Identifier
1790977973
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP03216 Issued in LA
Practice address
1111 Medical Ctr. Blvd.
N-613
Marrero, LA 70072
Phone
(504) 349-6800
Fax
(504) 349-6621
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN078784-AP03216 LA
Adult Health Nurse Practitioner 363LA2200X RN078784-AP03216 LA
Adult Health Nurse Practitioner 363LA2200X AP03216 LA Primary

Addresses

Primary practice location

1111 Medical Ctr. Blvd.
N-613
Marrero, LA 70072

Mailing address

1111 Medical Ctr. Blvd.
N-613
Marrero, LA 70072
Phone (504) 349-6800

Other identifiers 1

IdentifierTypeStateIssuer
1540315MedicaidLA

Other names 1

  • Tracy Lynn Melancon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20080117000028 LA Practitioner - Nurse Practitioner 1658452552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Orleans Physician Services IncGroup PAC ID 5294057824, 177 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone (504) 349-2427

1101 Medical Ctr Blvd ER
Marrero, LA 70072-3147
Phone (504) 349-1533

4513 Westbank Expressway
Marrero, LA 70072
Phone (504) 349-6360

Hospital & facility affiliations

  • West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Merit-based Incentive Payment System (MIPS)

Final score
78.64 of 100Reported as group
Quality
68.02
Improvement activities
40
Cost
76.01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP03216LAMDAdult Health Nurse Practitioner
RN078784-AP03216LAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New Orleans Physician Services Inc Nurse Practitioner CurrentSince Jan 1, 2015 Accepting new patients
Heart Clinic of Louisiana Diagnostic Services, Apmc Past Accepting new patients
Heart Clinic of Louisiana Past Accepting new patients
East Jefferson Physicians Group LLC Past Accepting new patients

Locations

120 Ochsner Blvd
Ste 410
Gretna, LA 70056

2845 Manhattan Blvd
Harvey, LA 70058
Phone (504) 349-6930

3909 Lapalco Blvd
Ste 200
Harvey, LA 70058
Phone (504) 349-6216

1111 Medical Center Blvd
#N61
Marrero, LA 70072

1111 Medical Center Blvd
Ste N613
Marrero, LA 70072
Phone (504) 349-6622

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

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.

Hospital & facility affiliations 2

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": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1790977973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CTR. BLVD.",
            "address_2": "N-613",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-6800",
            "fax_number": "504-349-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CTR. BLVD.",
            "address_2": "N-613",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "70072",
            "telephone_number": "504-349-6800",
            "fax_number": "504-349-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "TRACY",
        "middle_name": "MELANCON",
        "name_prefix": "Mrs.",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "RN078784-AP03216",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN078784-AP03216",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "AP03216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1540315",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MELANCON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.