NPIMap

Individual provider Active NPI

Traci A Williams, M.D.

  • Pediatrics Physician
  • Ventura, CA
National Provider Identifier
1043233620
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A66550 Issued in CA
Practice address
2953 Telegraph Rd
Ventura, CA 93003-3214
Phone
(805) 652-5252
Fax
(805) 652-0097
NPI assigned
Jul 25, 2006
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66550 CA
Pediatrics Physician 208000000X A66550 CA Primary

Addresses

Primary practice location

2953 Telegraph Rd
Ventura, CA 93003-3214

Mailing address

2953 Telegraph Rd
Ventura, CA 93003-3214
Phone (805) 652-5252

Other identifiers 1

IdentifierTypeStateIssuer
00A665500MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040218000826 CA Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Pediatric Medicine 0648165654 Reassigns benefits to 1 organization
I20160815001236 CA Practitioner - Pediatric Medicine 0648165654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Medical Group of Ventura County IncGroup PAC ID 0345218160, 42 clinicians

Practice addresses (Care Compare)

10885 Telegraph Rd
Ventura, CA 93004-1272
Phone (805) 647-7704

2772 Johnson Dr
Suite 200
Ventura, CA 93003-7262
Phone (805) 642-1430

3555 Loma Vista Rd
Suite 110
Ventura, CA 93003-3161
Phone (805) 653-0303

888 W Ventura Blvd
Suite a
Camarillo, CA 93010-8803
Phone (805) 383-7701

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Medical Group of Ventura County Inc CurrentSince Jun 20, 2016 Accepting new patients
Beaver Medical Group P C CurrentSince Jan 15, 2015 Accepting new patients
Beaver Medical Group P C Internal Medicine CurrentSince Jan 15, 2015 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

10885 Telegraph Rd
Ventura, CA 93004
Phone (805) 647-7704

2772 Johnson Dr
Ste 100
Ventura, CA 93003
Phone (805) 642-1430

2953 Telegraph Rd
Ventura, CA 93003
Phone (805) 652-5252

3555 Loma Vista Rd
Ste 110
Ventura, CA 93003
Phone (805) 653-0303

Interoperability endpoints

  • Direct secure messaging: traci.williams.1@21226.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1043233620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2953 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033214",
            "telephone_number": "805-652-5252",
            "fax_number": "805-652-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2953 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033214",
            "telephone_number": "805-652-5252",
            "fax_number": "805-652-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TRACI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66550",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A66550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A665500",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.