Individual provider Active NPI

Tracey Elaine Holmes, LCSW

  • Clinical Social Worker
  • Richmond Hill, NY
National Provider Identifier
1841472008
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
096800 Issued in NY
Practice address
8900 Van Wyck Expy
Richmond Hill, NY 11418-2897
Phone
(718) 206-6000
NPI assigned
Nov 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 096800 NY Primary

Addresses

Primary practice location

8900 Van Wyck Expy
Richmond Hill, NY 11418-2897

Mailing address

138 N Central Ave Apt 2B
Valley Stream, NY 11580-3852
Phone (718) 206-6000

Other identifiers 1

IdentifierTypeStateIssuer
096800OtherNYLCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240207000255 NY Practitioner - Clinical Social Worker 1052754058 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
096800NYMDSocial Worker
085805NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Hospital CurrentSince Jan 29, 2024 Accepting new patients
Amb Medical Services, P.C. CurrentSince Jan 1, 2025 Accepting new patients
Lana Gaiton Psychological Services, PC CurrentSince Dec 26, 2023 Accepting new patients
Jamaica Hospital CurrentSince Jan 29, 2024 Accepting new patients
Holmes Wellness Group LLC Clinical Current Accepting new patients

Locations

2502 86th St
Fl 3
Brooklyn, NY 11214
Phone (347) 391-4205

11247 Queens Blvd
Forest Hills, NY 11375
Phone (347) 391-4250

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

8900 Van Wyck Expy
Richmond Hill, NY 11418
Phone (718) 206-6088

6655 Fresh Pond Rd
Ridgewood, NY 11385
Phone (718) 497-1919

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1841472008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N CENTRAL AVE APT 2B",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115803852",
            "telephone_number": "718-206-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 VAN WYCK EXPY",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114182897",
            "telephone_number": "718-206-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMES",
        "first_name": "TRACEY",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "096800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.