Tracey Goldman, is a medicare enrolled "Nurse Practitioner - Family" in Yazoo, Mississippi. Her current practice location is
2225 Haley Barbour Parkway, Yazoo, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(601) 260-6330.
Tracey Goldman is licensed to practice in Mississippi (license number 901381) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1336688050.
Provider's Profile
Full Name | Tracey Goldman |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 2225 Haley Barbour Parkway, Yazoo, Mississippi |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1336688050
- Provider Enumeration Date: 02/14/2017
- Last Update Date: 01/11/2019
Medicare PECOS Information:
- PECOS PAC ID: 4880023977
- Enrollment ID: I20200413001062
Medical Identifiers
Medical identifiers for Tracey Goldman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1336688050 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 901381 (Mississippi) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Tracey Goldman allows following entities to bill medicare on her behalf.
Entity Name | State Of Mississippi - University Of Mississippi Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154317527 PECOS PAC ID: 1850293036 Enrollment ID: O20090414000575 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tracey Goldman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tracey Goldman, 2125 Scanlon Drive, Jackson, MS 39204 Ph: () - | Tracey Goldman, 2225 Haley Barbour Parkway, Yazoo, MS 39204 Ph: (601) 260-6330 |
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