Individual provider Active NPI

Tracy Marie Peveto, R.N., MSN, FNP-C

  • Family Nurse Practitioner
  • Orange, TX
National Provider Identifier
1093962722
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP116915 Issued in TX
Practice address
2014 10TH St
Orange, TX 77630-3431
Phone
(409) 266-1888
Fax
(409) 883-3147
NPI assigned
Aug 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP116915 TX
Family Nurse Practitioner 363LF0000X AP116915 TX Primary

Addresses

Primary practice location

2014 10TH St
Orange, TX 77630-3431

Mailing address

PO Box 650859
Dept 710
Dallas, TX 75265-5302
Phone (409) 747-6240

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090312000656 TX Practitioner - Nurse Practitioner 5890851034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2014 10TH St
Orange, TX 77630-3431
Phone (409) 883-6119

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
73.38
Improvement activities
40
Cost
78.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP116915TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Oct 15, 2009 Accepting new patients

Locations

701 E Davis St
Ste A
Conroe, TX 77301
Phone (936) 525-2800

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2014 10th St
Orange, TX 77630
Phone (409) 883-6119

Interoperability endpoints

  • Direct secure messaging: tpevetofnp16733@direct.utmb.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1093962722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650859",
            "address_2": "DEPT 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752655302",
            "telephone_number": "409-747-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 10TH ST",
            "city": "ORANGE",
            "state": "TX",
            "postal_code": "776303431",
            "telephone_number": "409-266-1888",
            "fax_number": "409-883-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVETO",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "R.N., MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP116915",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP116915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, TX

Sources for this page

Verify at the official NPI Registry.