Tracie Pham Gardner, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

R71171 Issued in AZ

Practice address

800 Washington St
Box #802
Boston, MA 02111-1552

Phone

(617) 636-1152

NPI assigned

Dec 23, 2008

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Pratt Pathology Associates, Inc

  dba Pratt Associates

  • Anatomic Pathology Physician
  • Boston, MA
  • NPI 1659312189
  NPD (past)
• Tufts Medical Center

  • Clinical Medical Laboratory
  • Boston, MA
  • NPI 1538478797
  NPD (past)

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351036800000",
    "number": "1912143835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX #802",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX #802",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "TRACIE",
        "middle_name": "PHAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-23",
        "last_updated": "2012-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "R71171",
            "primary": true
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "CA",
            "license": "A110863",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R71171",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "A110863",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Kristin Gardner
• Rachel Gardner
• Roxane Gardner, MD
• Ryan Mackenzie Gardner, MD
• Steven Hedden Gardner, MD MPH
• William M Gardner
• Rejean Gareau, M.D.
• Keri-Lee Alyson Garel, MD
• Joseph M Garfield, MD
• Hitesh Garg, DDS

• Anatomic Pathology & Clinical Pathology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; 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.