Individual provider Active NPI

Tracy Shin Peck Holcomb

  • Audiologist-Hearing Aid Fitter
  • San Francisco, CA
National Provider Identifier
1881894368
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
AU 2635 Issued in CA
Practice address
1234 Divisadero St
San Francisco, CA 94115-3911
Phone
(415) 921-7658
Fax
(415) 921-2243
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AU 2635 CA Primary

Addresses

Primary practice location

1234 Divisadero St
San Francisco, CA 94115-3911

Mailing address

45 San Clemente Dr Ste D140
Corte Madera, CA 94925-1210
Phone (415) 927-1567

Other names 1

  • Tracy Shin Peck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150410000915 CA Practitioner - Qualified Audiologist 3577881382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iron Audiology, Inc.Group PAC ID 4789575689, 5 clinicians

Practice addresses (Care Compare)

45 San Clemente Dr
Suite D140
Corte Madera, CA 94925-1210
Phone (415) 927-1567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AU 2635CAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Iron Audiology, Inc. Audiologist-Hearing Aid Fitter CurrentSince Jul 1, 2024 Accepting new patients

Locations

45 San Clemente Dr
Ste D14
Corte Madera, CA 94925

45 San Clemente Dr
Ste D140
Corte Madera, CA 94925
Phone (415) 381-1567

1515 Scott St
#2
San Francisco, CA 94115
Phone (415) 346-6886

Organizations & group practices 1

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1881894368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SAN CLEMENTE DR STE D140",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251210",
            "telephone_number": "415-927-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 DIVISADERO ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153911",
            "telephone_number": "415-921-7658",
            "fax_number": "415-921-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK HOLCOMB",
        "first_name": "TRACY",
        "middle_name": "SHIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU 2635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "PECK",
            "middle_name": "SHIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.