NPIMap

Individual provider Active NPI

Tracy Erik Sedano, APRN, FNP-C

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1083249700
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211875 Issued in LA
Practice address
2640 Country Club Rd Ste 400
Lake Charles, LA 70605-6079
Phone
(337) 426-0919
NPI assigned
Mar 4, 2020
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 211875 LA Primary

Addresses

Primary practice location

2640 Country Club Rd Ste 400
Lake Charles, LA 70605-6079

Mailing address

1316 Lasalette Ave
Sulphur, LA 70663-5632
Phone (337) 540-4934

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200330002354 LA Practitioner - Nurse Practitioner 7810326600 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Charles Urgent CareGroup PAC ID 1052580644, 14 clinicians
Lcuc Family Physicians Urgent Care LLCGroup PAC ID 8325327935, 13 clinicians

Practice addresses (Care Compare)

1905 Country Club Rd
Lake Charles, LA 70605-5203
Phone (337) 990-8000

2400 Ryan St
Lake Charles, LA 70601-7322
Phone (337) 433-1260

301 S Cities Service Hwy
Sulphur, LA 70663-6405
Phone (337) 888-3171

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
211875LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Urgent Care, LLC CurrentSince Feb 13, 2020 Accepting new patients
Lake Charles Urgent Care CurrentSince Mar 7, 2022 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Feb 13, 2020 Accepting new patients
Lcuc Family Physicians Urgent Care LLC CurrentSince Mar 7, 2022 Accepting new patients
Lake Charles Primary Care and Wellness Past Accepting new patients

Locations

1905 Country Club Rd
Lake Charles, LA 70605
Phone (337) 990-8000

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

242 Sam Houston Jones Pkwy
Moss Bluff, LA 70611
Phone (337) 905-4000

301 S Cities Service Hwy
Sulphur, LA 70663
Phone (337) 527-6416

Organizations & group practices 5

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1083249700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 LASALETTE AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635632",
            "telephone_number": "337-540-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 COUNTRY CLUB RD STE 400",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056079",
            "telephone_number": "337-426-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDANO",
        "first_name": "TRACY",
        "middle_name": "ERIK",
        "name_prefix": "Mr.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "211875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.