MEDICARE: TRACEY LY PA-C

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	363A00000X	Physician Assistant	0110009247	VA
2	363A00000X	Physician Assistant	58446	CA
3	363A00000X	Physician Assistant	031055	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356962211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY LY PA-C

Provider Business Mailing Address
First Line	:	6275 E VIRGINIA BEACH BLVD STE 300
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-2851
Country	:	US
Telephone Number	:	757-466-0089
Fax Number	:	757-466-8017

Provider Business Practice Location Address
First Line	:	600 GRESHAM DR STE 700
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-1904
Country	:	US
Telephone Number	:	757-388-1700
Fax Number	:	423-826-1290

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

Provider Enumeration Date	:	05/01/2020
Last Update Date	:	03/19/2026

Similar Medicare Providers

1003493859 — DEVIN PAGE RUSSELL MCINTOSH MD
Practice Location Address:

600 GRESHAM DR
NORFOLK, VA
23507-1904

Practice Phone: 757-446-8937
Practice Fax:

1417209610 — MICHAEL COLLINS HADLEY PA-C
Practice Location Address:

600 GRESHAM DR STE 8600
NORFOLK, VA
23507-1904

Practice Phone: 757-388-6005
Practice Fax:

1437684388 — JORDYN P SIEGEL M.D.
Practice Location Address:

600 GRESHAM DR STE 1100
NORFOLK, VA
23507-1904

Practice Phone: 757-668-9853
Practice Fax:

1669092060 — LAURA ANN FRIDAY PA-C
Practice Location Address:

600 GRESHAM DR
NORFOLK, VA
23507-1904

Practice Phone: 757-466-0089
Practice Fax: 757-466-8017

1265133854 — COURTNEY CRIPPS
Practice Location Address:

600 GRESHAM DR
NORFOLK, VA
23507-1904

Practice Phone: 757-388-3000
Practice Fax:

1386178911 — GABRIELLE ZOE MADSEN M.D.
Practice Location Address:

600 GRESHAM DR
NORFOLK, VA
23507-1904

Practice Phone: 757-388-3000
Practice Fax:

Directions to “ TRACEY LY PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.