Individual provider Active NPI

Tracy Bober, FNP

  • Family Nurse Practitioner
  • Wheeling, WV
National Provider Identifier
1962822189
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN64876 Issued in WV
Practice address
1 Medical Park
Suite 704
Wheeling, WV 26003
Phone
(304) 243-3134
Fax
(304) 243-3834
NPI assigned
Apr 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.16632-NP OH
Family Nurse Practitioner 363LF0000X APRN64876-FNP-BC WV
Family Nurse Practitioner 363LF0000X APRN64876 WV Primary

Addresses

Primary practice location

1 Medical Park
Suite 704
Wheeling, WV 26003

Mailing address

1 Medical Park
Suite 704
Wheeling, WV 26003
Phone (304) 243-3134

Other identifiers 1

IdentifierTypeStateIssuer
012655MedicaidOH

Other names 1

  • Tracy Nicole Yonak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150114000727 WV Practitioner - Nurse Practitioner 2466776836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeling Hospital IncGroup PAC ID 5799689493, 433 clinicians

Practice addresses (Care Compare)

1 Medical Park
Wheeling, WV 26003-6379
Phone (304) 243-3134

Hospital & facility affiliations

  • Wheeling Hospital, Inc Hospital, Wheeling, WV, CCN 510050
  • Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
COA.16632-NPOHMDFamily Nurse Practitioner
APRN64876WVMDFamily Nurse Practitioner
APRN64876-FNP-BCWVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeling Hospital Inc CurrentSince Apr 7, 2015 Accepting new patients
Wheeling Hospital, Inc. Past Accepting new patients
Wheeling Hospital Inc Past Accepting new patients

Locations

1 Medical Park
Wheeling, WV 26003
Phone (304) 243-3124

1 Medical Park
Ste 704
Wheeling, WV 26003
Phone (304) 243-3134

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.

Hospital & facility affiliations 2

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": "1398556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1962822189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3134",
            "fax_number": "304-243-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK",
            "address_2": "SUITE 704",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "26003",
            "telephone_number": "304-243-3134",
            "fax_number": "304-243-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBER",
        "first_name": "TRACY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-27",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.16632-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN64876-FNP-BC",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "APRN64876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012655",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "YONAK",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

Verify at the official NPI Registry.