Individual provider Active NPI

Tracy Diane Lynde, FNP-BC

  • Family Nurse Practitioner
  • Honolulu, HI
National Provider Identifier
1952772519
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-2893 Issued in HI
Practice address
550 S Beretania St Ste 403
Honolulu, HI 96813-2496
Phone
(808) 686-4770
NPI assigned
Oct 8, 2015
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173002 VA
Family Nurse Practitioner 363LF0000X APRN-2893 HI Primary

Addresses

Primary practice location

550 S Beretania St Ste 403
Honolulu, HI 96813-2496

Mailing address

550 S Beretania St Ste 403
Honolulu, HI 96813-2496
Phone (808) 686-4770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20210305001324 HI Practitioner - Nurse Practitioner 8123321437 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

550 S Beretania St
Honolulu, HI 96813-2496

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.05 of 100Reported as apm
Quality
89.81
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-2893HIMDFamily Nurse Practitioner
0024173002VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates, Inc CurrentSince Apr 26, 2021 Accepting new patients
Queens University Medical Group CurrentSince May 22, 2023 Accepting new patients
Commonwealth Emergency Physicians PC PastSince Apr 17, 2020 Accepting new patients
John J Cogan MD Inc Past Accepting new patients

Locations

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

1380 Lusitana St
Ste 1007
Honolulu, HI 96813
Phone (808) 521-2992

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

550 S Beretania St
Ste 403
Honolulu, HI 96813
Phone (808) 523-5033

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1952772519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 403",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-686-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S BERETANIA ST STE 403",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968132496",
            "telephone_number": "808-686-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNDE",
        "first_name": "TRACY",
        "middle_name": "DIANE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173002",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "APRN-2893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.