DR. TRACY LYNN IVY (MD) – Pediatric Pulmonology Physician, NPI 1710111331
Pediatric Pulmonology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
411 PULMONARY DISEASE in MO
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Provider Addresses for DR. TRACY LYNN IVY (MD)
PO BOX 7412011
CHICAGO, IL 606742011
Phone: (314) 454-2694
Fax: (314) 454-2515
Type: Mailing
660, South Euclid Avenue, Central West End, City of Saint Louis, Missouri, 63110, United States
C B 8116
SAINT LOUIS, MO 631101010
Phone: (314) 454-2694
Fax: (314) 454-2515
Type: Mailing
Saint Louis Childrens Hospital School, 1, Children's Place, Central West End, City of Saint Louis, Missouri, 63110, United States
DIV PED ALLERGY/IMMUNO/PULMO
SAINT LOUIS, MO 631101002
Phone: (314) 454-2694
Fax: (314) 454-2515
Type: Location
1 CHILDRENS PL
MSC 8515-87-1200
SAINT LOUIS, MO 631101002
Phone: (314) 454-2694
Fax: (314) 454-2515
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-02-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170203001463 | I | Pulmonary Disease | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60674)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| - | MO | |
| - | FL | |
| - | MO | |
| Diagnostic Radiology | IL | |
| - | IL | |
| - | MO | |
| - | MO | |
| - | MO | |
| - | MO |
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