Individual provider Active NPI

Tracie Denise Swayden, MD

  • Dermatopathology Physician
  • Hurst, TX
National Provider Identifier
1093865545
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
L8526 Issued in TX
Practice address
804 NE Mall Blvd
Hurst, TX 76053-4653
Phone
(817) 595-4500
Fax
(817) 595-4505
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X L8526 TX Primary

Addresses

Primary practice location

804 NE Mall Blvd
Hurst, TX 76053-4653

Mailing address

804 NE Mall Blvd
Hurst, TX 76053-4653
Phone (817) 595-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070515000569 TX Practitioner - DermatologyPractitioner - General Practice 6800993486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: General Practice
Education
University of Texas Medical School at San Antonio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin MD PA 5 clinicians

Practice addresses (Care Compare)

750 Eureka St
Suite a
Weatherford, TX 76086-6521
Phone (817) 550-6073

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions318
Removal or shaving of skin growth1-10
Skin biopsy104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Skin MD PA CurrentSince Mar 15, 2010 Accepting new patients
Americare Medical Group, Inc. Past Accepting new patients

Locations

206 Elm St
Aledo, TX 76008

600 S Harbor Ct
Granbury, TX 76048
Phone (817) 326-3134

750 Eureka St
Ste A
Weatherford, TX 76086
Phone (817) 405-2689

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1093865545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 NE MALL BLVD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534653",
            "telephone_number": "817-595-4500",
            "fax_number": "817-595-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 NE MALL BLVD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760534653",
            "telephone_number": "817-595-4500",
            "fax_number": "817-595-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAYDEN",
        "first_name": "TRACIE",
        "middle_name": "DENISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "L8526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.