Provider Demographics
NPI:1417018409
Name:GARY E TRATT MD PC
Entity Type:Organization
Organization Name:GARY E TRATT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:TRATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:508-771-5300
Mailing Address - Street 1:66 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601
Mailing Address - Country:US
Mailing Address - Phone:508-771-5300
Mailing Address - Fax:508-775-3362
Practice Address - Street 1:66 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:508-771-5300
Practice Address - Fax:508-775-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30714207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5388221OtherCIGNA
MA9724311Medicaid
11666OtherJOHN HANCOCK COMMONWEALTH
6664OtherUS HEALTHCARE
M12346OtherBLUE SHIELD
0400747OtherUNITED HEALTHCARE
60132OtherHARVARD PILGRIM
726169OtherTUFTS
GAM12346OtherBLUE SHIELD
M12346Medicare ID - Type Unspecified
5388221OtherCIGNA