Individual provider Active NPI

Mark S Tracy, DPM

  • Podiatrist
  • Port Charlotte, FL
National Provider Identifier
1962436030
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO1878 Issued in FL
Practice address
3028 Caring Way
Ste 9
Port Charlotte, FL 33952-5300
Phone
(941) 627-6366
Fax
(941) 627-6677
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO1878 FL Primary

Addresses

Primary practice location

3028 Caring Way
Ste 9
Port Charlotte, FL 33952-5300

Mailing address

3028 Caring Way
Ste 9
Port Charlotte, FL 33952-5300
Phone (941) 627-6366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100625000437 FL Practitioner - Podiatry 9739183336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael T. McCormick and Associates PAGroup PAC ID 1759521933, 5 clinicians

Practice addresses (Care Compare)

115 Shamrock Blvd
Venice, FL 34293-1630
Phone (941) 493-8666

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue39
Removal of skin lesions1-10
Removal of nail tissue290
Removal or shaving of skin growth90
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael T. McCormick & Associates PA Podiatrist CurrentSince Nov 1, 2022 Accepting new patients
Michael T. McCormick & Associates PA Podiatrist CurrentSince Nov 1, 2022 Accepting new patients
Caring Way Primary Care Clinic PastSince Jan 1, 2023 Accepting new patients

Locations

17835 Murdock Cir
Unit B
Port Charlotte, FL 33948

115 Shamrock Blvd
Venice, FL 34293
Phone (941) 493-8666

Interoperability endpoints

  • Direct secure messaging: mtracy@usfas.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1962436030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 CARING WAY",
            "address_2": "STE 9",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525300",
            "telephone_number": "941-627-6366",
            "fax_number": "941-627-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3028 CARING WAY",
            "address_2": "STE 9",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525300",
            "telephone_number": "941-627-6366",
            "fax_number": "941-627-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACY",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.