Tracy Elisa Blatt, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS009077L Issued in PA

Practice address

8080 Old York Rd Ste 224
Elkins Park, PA 19027-1421

Phone

(267) 626-2018

Fax

(267) 636-5205

NPI assigned

Sep 24, 2016

Last updated

Jun 1, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1474675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559347200000",
    "number": "1871042465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 DEERFIELD CT",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222126",
            "telephone_number": "610-203-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 OLD YORK RD STE 224",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271421",
            "telephone_number": "267-626-2018",
            "fax_number": "267-636-5205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "702 Hyde Park",
            "address_purpose": "LOCATION",
            "city": "Doylestown",
            "state": "PA",
            "postal_code": "189026613",
            "country_code": "US",
            "telephone_number": "215-589-7111",
            "fax_number": "215-589-7115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 Virginia Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343103",
            "country_code": "US",
            "telephone_number": "215-367-5446",
            "fax_number": "267-470-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLATT",
        "first_name": "TRACY",
        "middle_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-24",
        "last_updated": "2019-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS009077L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.