Individual provider Active NPI

Tracey M. Butler, CRNA

  • Certified Registered Nurse Anesthetist
  • Youngstown, OH
National Provider Identifier
1821051012
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN.395377 Issued in OH
Practice address
8401 Market St
Youngstown, OH 44512
Phone
(330) 729-2929
NPI assigned
Apr 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1103844 TX
Certified Registered Nurse Anesthetist 367500000X RN.395377 OH Primary

Addresses

Primary practice location

8401 Market St
Youngstown, OH 44512

Mailing address

4135 Boardman Canfield Rd Ste 101
Canfield, OH 44406-9803
Phone (330) 286-5330

Other practice location 1

1200 7th Ave N
St Petersburg, FL 33705-1300
Phone (727) 825-1486

Other practice location 2

1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658

Other practice location 3

1720 S Beckham Ave Ste 104
Tyler, TX 75701-4437
Phone (903) 606-3900

Other practice location 4

8389 S Broadway Ave
Tyler, TX 75703-5408
Phone (903) 606-6500

Other practice location 5

910 E Houston St Ste 400
Tyler, TX 75702-8368
Phone (903) 606-5300

Other practice location 6

800 E Dawson St
Tyler, TX 75701-2036
Phone (903) 525-2668

Other identifiers 4

IdentifierTypeStateIssuer
P01356545OtherOHMEDICARE RAILROAD
H190010OtherOHMEDICARE PTAN
000000838469OtherOHANTHEM BCBS
2643812MedicaidOH

Other names 1

  • Tracey M. Focht-Tilton Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131018000635 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092729731 Reassigns benefits to 1 organization
I20230503001672 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092729731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 E Dawson St
Tyler, TX 75701-2036

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1103844TXMDPhysical Therapist
RN.395377OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia III PA Nurse Anesthetist, Certified Registered CurrentSince Jun 30, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 20, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jun 20, 2023 Accepting new patients
Mother Frances Hospital Regional Health Care Center CurrentSince Jun 20, 2023 Accepting new patients
Bel-Park Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 14, 2013 Accepting new patients
Gulfcoast Anesthesia Partners LLP Past Accepting new patients
Mother Frances Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients
Western Pennsylvania Anesthesia Associates, LTD. Past Accepting new patients

Locations

4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

3315 S Alameda St
Corpus Christi, TX 78411
Phone (361) 761-1400

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

8389 S Broadway Ave
Tyler, TX 75703
Phone (903) 606-4129

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

1720 S Beckham Ave
Ste 104
Tyler, TX 75701
Phone (903) 597-2002

910 E Houston St
Ste 400
Tyler, TX 75702
Phone (903) 531-4268

Organizations & group practices 8

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 1

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": "1144540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1821051012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 BOARDMAN CANFIELD RD STE 101",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069803",
            "telephone_number": "330-286-5330",
            "fax_number": "330-286-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44512",
            "telephone_number": "330-729-2929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 7th Ave N",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051300",
            "country_code": "US",
            "telephone_number": "727-825-1486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445041006",
            "country_code": "US",
            "telephone_number": "330-480-3658",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1720 S Beckham Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757014437",
            "country_code": "US",
            "telephone_number": "903-606-3900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8389 S Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757035408",
            "country_code": "US",
            "telephone_number": "903-606-6500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "910 E Houston St Ste 400",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028368",
            "country_code": "US",
            "telephone_number": "903-606-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 E Dawson St",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012036",
            "country_code": "US",
            "telephone_number": "903-525-2668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "TRACEY",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-09",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "1103844",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN.395377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01356545",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H190010",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000838469",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2643812",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "FOCHT-TILTON",
            "middle_name": "M.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.