Individual provider Active NPI

Tracie L Overbeck, MD, PHD

  • Allergy & Immunology Physician
  • Lexington, KY
National Provider Identifier
1881658805
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
40012 Issued in KY
Practice address
166 Pasadena Drive Suite 150
Lexington, KY 40503-2938
Phone
(859) 276-1452
Fax
(859) 277-1237
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 40012 KY Primary

Addresses

Primary practice location

166 Pasadena Drive Suite 150
Lexington, KY 40503-2938

Mailing address

Dept. 453 PO Box 1000
Memphis, TN 38148-0001
Phone (828) 575-2625

Other identifiers 2

IdentifierTypeStateIssuer
K092670OtherKYMEDICARE PTAN
64086788MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061229000120 KY Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 4385629575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Ohio State University College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy Partners PLLCGroup PAC ID 7113822420, 144 clinicians

Practice addresses (Care Compare)

166 Pasadena Dr
Suite 150
Lexington, KY 40503-2938
Phone (859) 276-1452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
40012KYMDAllergy & Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NPI 1508468638 Allergy & Immunology CurrentSince Jan 1, 2014 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology CurrentSince Jan 1, 2014 Accepting new patients
Allergy Partners, PLLC Allergy & Immunology Current Accepting new patients
Allergy & Asthma Physicians of Central Kentucky, PSC Allergy & Immunology PastSince Jul 1, 2009 Accepting new patients

Locations

166 Pasadena Dr
Ste 150
Lexington, KY 40503
Phone (859) 276-1452

Organizations & group practices 3

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1881658805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. 453 PO BOX 1000",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "828-575-2625",
            "fax_number": "828-350-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 PASADENA DRIVE SUITE 150",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032938",
            "telephone_number": "859-276-1452",
            "fax_number": "859-277-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERBECK",
        "first_name": "TRACIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "40012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K092670",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64086788",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.