NPIMap

Organization Active NPI

Family Medical & Maternity Care PC

  • Family Medicine Physician
  • Leominster, MA
National Provider Identifier
1922170216
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
152307 Issued in MA
Legal business name
FAMILY MEDICAL & MATERNITY CARE PC
Practice address
87 North Main St
Leominster, MA 01453
Phone
(978) 534-8701
Fax
(978) 534-8705
NPI assigned
Nov 14, 2006
Last updated
Apr 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Authorized official

Name
Dr. Audrey Tracey, MDNPI 1558329433
Title
Owner
Phone
(978) 534-8701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 152307 MA Primary

Addresses

Primary practice location

87 North Main St
Leominster, MA 01453

Mailing address

87 North Main St
Leominster, MA 01453
Phone (978) 534-8701

Other identifiers 1

IdentifierTypeStateIssuer
9723111MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050613000594 MA Part B Supplier - Clinic/Group Practice 6901840859 Receives reassigned benefits from 26 practitioners
Practice locations: Leominster, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0981131Family Medical & Maternity Care, PC87 N Main St, Leominster, MA 01453Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAJFCA

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1922170216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 NORTH MAIN ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-8701",
            "fax_number": "978-534-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 NORTH MAIN ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-8701",
            "fax_number": "978-534-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL & MATERNITY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "TRACEY",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-534-8701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "152307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9723111",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.