Tracy Pavone, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

2697 Issued in GA

Practice address

3100 Kemble Ave
Brunswick, GA 31520-4211

Phone

(912) 264-7000

NPI assigned

Jan 29, 2007

Sex

Male

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 GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Emory University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alta Anesthesia Associates of Georgia, PCGroup PAC ID 8729992987, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

Practice roles

Locations

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.

• Alta Anesthesia Associates of Georgia, PC

  • Anesthesiology Physician
  • Brunswick, GA
  • NPI 1275504771

  Physician Assistant

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Brunswick Campus

  • General Acute Care Hospital
  • Brunswick, GA
  • NPI 1598784720
  Care Compare affiliation

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1881730984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 KEMBLE AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204211",
            "telephone_number": "912-264-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVONE",
        "first_name": "TRACY",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002697",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "2697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suhena Patel
• Yash Patel
• Jennifer Sue Patterson, ANP
• Luis F Paucar, OCCUPATIONAL THERAPI
• Efthimia Pavlou, M.D.
• Lauren Pearl
• Pediatric Associates of Brunswick
• Pediatric Therapies of SE Ga, LLC
• Peds 'R US, P.C.
• Guy Peffer, LPC

• Anesthesiologist Assistant in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.