DR. TRACIE PHAM GARDNER (NPI# 1912143835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912143835 |
| Entity Type | Individual |
| Full Name | DR. TRACIE PHAM GARDNER |
| Credential | M.D. |
| Practice Address |
800 Washington St Box #802 Boston MA 02111-1552 |
| Practice Telephone | 6176361152 |
| Mailing Telephone | 6176361152 |
| Enumeration Date | 2008-12-23 |
| Last Update Date | 2012-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZN0500X |
Pathology Specialization: Neuropathology |
A110863 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
R71171 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TRAINING PERMIT | R71171 | 01 | |
| CA | CALIFORNIA MEDICAL LICENSE | A110863 | 01 |
| Street Address |
800 WASHINGTON ST BOX #802 |
| City | BOSTON |
| State | MA |
| Zip Code | 02111-1552 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848643 | Christopher B. Geary | Orthopaedic Surgery | 800 Washington St, Box 306, Boston, MA 02111-1552 | 2005-06-01 |
| 1720687767 | Johnson Ching | Pharmacist | 800 Washington St, Boston, MA 02111-1552 | 2020-10-21 |
| 1174120075 | Sarah Woodruff | Nurse Practitioner | 800 Washington St, Boston, MA 02111-1552 | 2020-10-04 |
| 1255946448 | Tufts Medical Center | Surgery | 800 Washington St, Boston, MA 02111-1552 | 2020-09-14 |
| 1639784408 | Pankaj Jain | Internal Medicine | 800 Washington St, Boston, MA 02111-1552 | 2020-09-09 |
| 1053926907 | Arlind Decka | Surgery | 800 Washington St, Boston, MA 02111-1552 | 2020-09-08 |
| 1518571124 | Abdulrahman Mohammad Alshiban | Psychiatry & Neurology | 800 Washington St, Boston, MA 02111-1552 | 2020-09-01 |
| 1922610229 | Taylor Elizabeth Maffett | Nurse Practitioner | 800 Washington St, Boston, MA 02111-1552 | 2020-08-18 |
| 1467063685 | Heather April Mills Tong | Physical Therapist | 800 Washington St, Boston, MA 02111-1552 | 2020-08-11 |
| 1245840032 | Lindsey Holland | Nurse Practitioner | 800 Washington St, Boston, MA 02111-1552 | 2020-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271397 | Maximilian Richert | Counselor | 25 Kingston St, 4r, Boston, MA 02111 | 2020-10-06 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1548883465 | Elizabeth Carter Stapleton | Dentist | Tufts School of Dental Medicine: Dept of Orthodontics, 1 Kneeland Street, Boston, MA 02111 | 2020-05-27 |
| 1932729597 | Jacob Joseph Kosarchuk | Neurological Surgery | 800 Washington Street, Proger 7, Boston, MA 02111 | 2020-04-23 |
| 1164051868 | Daniele Abela | Surgery | 860 Washington Street, South Building, 4th Floor, Boston, MA 02111 | 2020-04-04 |
| 1184265258 | Jade Orthodontics | Dentist | 30 Kneeland St, Suite 301, Boston, MA 02111 | 2019-09-30 |
| 1932753639 | Loukia Kamille Danaf | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, Tufts University School of Dental Me, Boston, MA 02111 | 2019-07-31 |
| 1033771944 | Faris Khalifa | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 5th Floor, Boston, MA 02111 | 2019-07-01 |
| 1609437276 | Blair Hanna Ray Farbstein | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 3rd Floor, Boston, MA 02111 | 2019-06-25 |
| 1821658709 | Jennifer Drummond | Internal Medicine | 800 Washington St. Gme Office, Boston, MA 02111 | 2019-06-13 |
| Find all providers in zip 02111 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194219261 | Alicia Gabrielle Dessain | Pathology | Tufts Medical Center - Pathology Department, 800 Washington St, Boston, MA 02111 | 2018-06-21 |
| 1043748395 | Hanqiao Zheng | Pathology | 670 Albany St Ste 4, Boston, MA 02118 | 2017-05-31 |
| 1245688977 | Seyed Amin Hojat | Pathology | 800 Washington St., Box 115, Boston, MA 02111 | 2016-06-03 |
| 1578976817 | Madhu Ouseph | Pathology | 75 Francis St # 360h, Boston, MA 02115 | 2014-06-04 |
| 1578975124 | Saja Asakrah | Pathology | 330 Brookline Ave Fl 2, Boston, MA 02215-5400 | 2014-05-29 |
| 1598028409 | Austin G Turner | Pathology | 800 Washington St # 836, Boston, MA 02111-1552 | 2012-06-18 |
| 1104115559 | Anita Deshpande | Pathology | 1 Boston Medical Ctr Pl # Place3, Boston, MA 02118-2908 | 2011-04-06 |
| 1801050026 | Earl J Kasdon | Pathology | Office of The Chief Medical Examiner, 720 Albany Street, Boston, MA 02118 | 2008-07-16 |
| 1487839551 | Mariana Alexandra Stoleru | Pathology | 750 Washington St. Nemc#802, Boston, MA 02111-1526 | 2008-01-08 |
| 1558482612 | Thomas H Aretz | Pathology | Mass General Hosp-pathology, 55 Fruit St, Boston, MA 02114 | 2007-04-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.