MEDICARE: TRACY A HARADON O. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3810	MA
2	152WC0802X	Corneal and Contact Management Optometrist	3810	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	970751	OTHER	MA	NETWORK HEALTH
2	2748922	OTHER	MD	CIGNA
3	50449	OTHER	MA	CHILDRENS MEDICAL SECURIT
4	5310173	OTHER	MA	AETNA
5	000000027519	OTHER	MA	BOSTON MEDICAL CENTER HEA
6	2215920	OTHER	MA	FIRST HEALTH
7	22-00401	OTHER	MA	EVERCARE SENIOR OPTIONS
8	19101	OTHER	MA	HEALTH NEW ENGLAND
9	410106	OTHER	MA	TUFTS HEALTH PLANS
10	AA11181	OTHER	MA	HARVARD PILGRIM
11	0030314	OTHER	MA	NEIGHBORHOOD HEALTH PLAN
12	W15973	OTHER	MA	BLUE CROSS BLUE SHIELD
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	2301488	OTHER	MA	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1023011228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY A HARADON O. D.

Provider Business Mailing Address
First Line	:	453 SUMNER AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-2320
Country	:	US
Telephone Number	:	413-733-5155
Fax Number	:	413-733-5119

Provider Business Practice Location Address
First Line	:	453 SUMNER AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-2320
Country	:	US
Telephone Number	:	413-733-5155
Fax Number	:	413-733-5119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/11/2025

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