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TRACY ROSTHOLDER
NPI 1669821732
Pediatrics in Mineola, NY

Active since June 08, 2016PECOS Enrolled
222 STATION PLZ N STE 611, MINEOLA, NY 11501(516) 663-2532(516) 663-4409 Get Directions Write a Review

NPPES record last updated: May 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2023, Feb 17, 2023, Feb 2, 2023 and 2 more (5 updates tracked since 2019).

About Tracy Rostholder NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACY ROSTHOLDER (NPI 1669821732) is an individual pediatrics provider in Mineola, New York, licensed in New York (299069) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669821732
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTRACY ROSTHOLDER
Location Address222 STATION PLZ N STE 611Mineola, NY 11501-3893
Mailing Address222 Station Plz N Ste 611Mineola, NY 11501-3893 · (516) 663-2532 · Fax (516) 663-4409
Phone(516) 663-2532
Fax(516) 663-4409
Sole ProprietorNo
Enumeration DateJune 8, 2016
Last NPPES UpdateMay 12, 20235 updates tracked since enumeration
NPPES CertifiedMay 12, 2023
✔ NPI 1669821732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NY · 299069
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
222 STATION PLZ N STE 611, Mineola, NY 11501
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tracy Rostholder is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Tracy Rostholder reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Kaleida Health
305 mi
General Acute Care Hospital
1540 MAPLE RD
Williamsville, NY 14221
  • Reassigned Medicare billing, New York enrollment
  • 676 clinicians in this Medicare group
NPI 1053441907 (716) 568-3600
University At Buffalo Pediatric Associates Inc
308 mi
Pediatrics
1001 MAIN ST FL 4
Buffalo, NY 14203
  • Reassigned Medicare billing, New York enrollment
  • 217 clinicians in this Medicare group
NPI 1912928599 (716) 323-0225
New York University
1,045 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 2,450 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALENA CONNELLY MD
Pediatrics
222 STATION PLZ N STE 611
MINEOLA, NY 11501
Nassau County (516) 663-2532

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tracy Rostholder's NPI number?

The NPI number for Tracy Rostholder is 1669821732. It was assigned to this individual provider in the NPPES registry on June 8, 2016.

Where is Tracy Rostholder located?

Tracy Rostholder practices at 222 Station Plz N Ste 611, Mineola, NY 11501. The listed phone number is (516) 663-2532.

What is Tracy Rostholder's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Tracy Rostholder enrolled in Medicare?

Yes. Tracy Rostholder is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Tracy Rostholder's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tracy Rostholder reassigns Medicare benefits to 3 organizations: Kaleida Health (Williamsville, NY), University At Buffalo Pediatric Associates Inc (Buffalo, NY) and New York University (Boynton Beach, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tracy Rostholder's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tracy Rostholder was last updated on May 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.