Tracy Broomell, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

62970 Issued in OR

Practice address

4025 Cherry Ave NE
Keizer, OR 97303-4859

Phone

(503) 390-9009

NPI assigned

Sep 28, 2018

Last updated

Sep 28, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fireweed Therapy LLCGroup PAC ID 6800251489, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Fireweed Therapy LLC

  • Occupational Therapist
  • Anchorage, AK
  • NPI 1922795277

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1861977530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7614 RAVENSWOOD DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245020",
            "telephone_number": "269-501-8640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMELL",
        "first_name": "TRACY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018836",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Star Marie Briggs-Trammell, RDH
• Luke Andrew Brinton, OD
• Tammy Marie Brister, QMHA
• Bradley Patton Brooker
• Nevaeh Brooks
• Jeffry Brown
• Patrick James Brown
• Kamme Brubeck
• Travis James Brueckner
• Raymond Brumbaugh, MD

• Physical Therapist in Keizer, OR
• Providers in Keizer, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.