TRACY TYSON (M.D.) – Pediatrics Physician, NPI 1205865045
Pediatrics Physician
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TRACY TYSON (M.D.)
PO BOX 45443
SALT LAKE CITY, UT 841450443
Phone: (904) 202-1032
Fax: (904) 376-4107
Type: Mailing
44 Center St
Enosburg Falls, VT 054505795
Phone: (802) 527-8189
Fax: (802) 933-8642
Type: Location
600 BLAIR PARK RD STE 285
WILLISTON, VT 054957586
Phone: (802) 288-1140
Fax: (802) 288-1144
Type: Mailing
11 CREST RD
SAINT ALBANS, VT 054789701
Phone: (802) 527-8189
Fax: (802) 527-8187
Type: Location
2140, Smith Street, Orange Park, Clay County, Florida, 32073, United States
ORANGE PARK, FL 320735554
Phone: (904) 269-2140
Fax: (904) 264-3018
Type: Location
66 KNIGHT LN STE 10
WILLISTON, VT 054959308
Phone: (802) 872-4329
Fax: (802) 288-1144
Type: Mailing
44 CENTER ST
ENOSBURG FALLS, VT 054505795
Phone: (802) 527-8189
Fax: (802) 933-8642
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2021-03-17
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 |
|---|---|---|---|---|
| I20210317001217 | I | Pediatric Medicine | VT | 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 84145)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.