Tracy Anselmo, APN
Individual provider Active NPI Family Nurse Practitioner · Atlantic City, NJ
NPI 1962980862 · NPPES record last updated Mar 3, 2021
Key facts
- NPI
- 1962980862
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 26NJ00842200 (NJ)
- Practice address
- 4401 Ventnor Ave Ste 3
Atlantic City, NJ 08401-5736 - Phone
- (603) 345-2050
- Fax
- (609) 345-2052
- NPI assigned
- Aug 2, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181204003863 | NJ | Practitioner - Nurse Practitioner | 7719221563 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Act on Total Health Medical Group, LLC | Family Medicine | Current |
Accepting new patients |
| Ra Pain Services PA | Pain Medicine | Current |
Accepting new patients |
| Medical Service Professionals of NJ LLC | Current |
Accepting new patients |
Locations
4401 Ventnor Ave
Ste 3
Atlantic City, NJ 08401
Phone (609) 344-1836
2354 US Highway 9
Howell, NJ 07731
Phone (732) 905-5255
30 Montgomery St
Fl 15
Jersey City, NJ 07302
Phone (551) 247-1029
125 Chubb Ave
Ste 100S
Lyndhurst, NJ 07071
Phone (201) 559-7600
15000 Midlantic Dr
Mount Laurel, NJ 08054
Phone (856) 380-2760
3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463
1634 New Rd
Northfield, NJ 08225
Phone (609) 272-0655
8025 Black Horse Pike
Ste 501
Pleasantville, NJ 08232
Phone (609) 464-1135
218 Sunset Rd
Willingboro, NJ 08046
Phone (609) 835-2900
Interoperability endpoints
- tracy.anselmo.1@24114.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ00842200 | NJ | Yes |
Addresses
Primary practice location
4401 Ventnor Ave Ste 3
Atlantic City, NJ 08401-5736
Mailing address
4401 Ventnor Ave Ste 3
Atlantic City, NJ 08401-5736
Phone (609) 345-2050
Other providers in Atlantic City, NJ
- Jasmina Anandpara
- Jinu Andrews
- Miriam Andrews
- Angels Medical LLC
- Jaclyn Ann Annunziata
- Cara Ann Anzulewicz
- Hasita Arekooti
- Maliaka Arif
- Mohammad Ashfaq
- Associates in Podiatric Medicine & Surgery, PC
All providers in Atlantic City, NJ · Family Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.