Individual provider Active NPI

Tracy M Young, FNP

  • Family Nurse Practitioner
  • Boise, ID
National Provider Identifier
1972562726
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP480 Issued in ID
Practice address
6259 W Emerald St
Boise, ID 83704-8731
Phone
(208) 489-1900
Fax
(208) 375-5286
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP480 ID Primary

Addresses

Primary practice location

6259 W Emerald St
Boise, ID 83704-8731

Mailing address

6259 W Emerald St
Boise, ID 83704-8731
Phone (208) 489-1900

Other names 1

  • Ms. Tracy M Lane Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20181026000475 WA Practitioner - Nurse Practitioner 8729037650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jamestown S'Klallam TribeGroup PAC ID 2365349495, 38 clinicians

Practice addresses (Care Compare)

526 S 9TH Ave
Sequim, WA 98382-3626
Phone (360) 683-5900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP480IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown S'Klallam Tribe CurrentSince Mar 4, 2024 Accepting new patients

Locations

526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755

808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840

Organizations & group practices 1

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 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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1972562726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048731",
            "telephone_number": "208-489-1900",
            "fax_number": "208-375-5286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048731",
            "telephone_number": "208-489-1900",
            "fax_number": "208-375-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "TRACY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "LANE",
            "middle_name": "M",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.