MS. TRACY MARIE SMITH PA-C NPI 1609109024

NPI Information

NPI: 1609109024
Provider Name: MS. TRACY MARIE SMITH, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
4190 CITY AVE
SUITE 528
PHILADELPHIA, PA
ZIP 19131
Phone: (866) 453-8800
Get Directions

MS. Tracy Marie Smith, PA-C is a medical physician assistant in Philadelphia, PA. MS. Tracy Marie Smith, PA-C NPI is 1609109024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4190 CITY AVE
SUITE 528
PHILADELPHIA, PA
ZIP 19131-626
Phone: (866) 453-8800
Fax: (844) 734-7689

The NPI 1609109024 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/16/2009 and was last updated on 9/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA21436	CALIFORNIA	No
2	363AM0700X	Physician Assistant	Medical	MA054091	PENNSYLVANIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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