Tracey Renee Connell, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61681 Issued in CA

Practice address

126 Glasson Way
Grass Valley, CA 95945-5706

Phone

(530) 272-2303

Fax

(530) 272-9648

NPI assigned

Feb 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tracey Renee Lim Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sierra Derm IncGroup PAC ID 3072589266, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.97 of 100Reported as group

Quality

100

Improvement activities

40

Cost

79.9

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: traceypa@sierraderm.emadirect.md

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.

• Sierra Derm Inc.

  • Dermatology Physician
  • Grass Valley, CA
  • NPI 1700818903
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1972835973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455706",
            "telephone_number": "530-272-2303",
            "fax_number": "530-272-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 GLASSON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455706",
            "telephone_number": "530-272-2303",
            "fax_number": "530-272-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "TRACEY",
        "middle_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-02",
        "last_updated": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA61681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "LIM",
            "middle_name": "RENEE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Common Purpose
• Erin Compton
• Jeff Donovan Conklin
• Melanie Conley, DPT
• Polly Kay Conley, R.N., P.N.P
• Erin Connolly, MS
• Tomi M Connors Corbett, PT
• Julia Conrad, MFT 86901
• Meghan Heather Conroy
• Sydney Cook, RADTI

• Physician Assistant in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.