Individual provider Active NPI

Tracy Mariano, WHNP

  • Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1942472857
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71003170A Issued in IN
Practice address
1481 W 10TH St
Indianapolis, IN 46202-2803
Phone
(317) 988-4917
Fax
(317) 988-4929
NPI assigned
Mar 31, 2008
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71003170A IN Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71003170B IN
Women's Health Nurse Practitioner 363LW0102X 28143782A IN
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 28143782A IN

Addresses

Primary practice location

1481 W 10TH St
Indianapolis, IN 46202-2803

Mailing address

1481 W 10TH St
Indianapolis, IN 46202-2803
Phone (317) 988-4917

Other identifiers 1

IdentifierTypeStateIssuer
71003170AOtherAPN PRES AUTHORITY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101120000045 IN Practitioner - Nurse Practitioner 7315133048 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71003170AINMDNurse Practitioner
71003170BINMDPsychiatric/Mental Health Nurse Practitioner
28143782AINMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America of Indiana, Inc Psychiatric/Mental Health CurrentSince Aug 8, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

927 N Pennsylvania St
Indianapolis, IN 46204
Phone (317) 686-5800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1942472857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-4917",
            "fax_number": "317-988-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-4917",
            "fax_number": "317-988-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIANO",
        "first_name": "TRACY",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003170A",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71003170B",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IN",
            "license": "28143782A",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IN",
            "license": "28143782A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN PRES AUTHORITY",
            "identifier": "71003170A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.