Individual provider Active NPI

Traci Bolster Biskupovich, NP

  • Nurse Practitioner
  • Gretna, LA
National Provider Identifier
1295003267
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP06648 Issued in LA
Practice address
501 Lapalco Blvd
Gretna, LA 70056-7336
Phone
(504) 393-4376
Fax
(504) 930-4307
NPI assigned
Dec 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06648 LA Primary

Addresses

Primary practice location

501 Lapalco Blvd
Gretna, LA 70056-7336

Mailing address

501 Lapalco Blvd
Gretna, LA 70056-7336
Phone (504) 393-4376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20120427000713 LA Practitioner - Nurse Practitioner 7810159399 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.78 of 100Reported as group
Quality
77.82
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP06648LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Emergency Group LLC Nurse Practitioner CurrentSince Nov 15, 2014 Accepting new patients
Kenner Emergency Group LLC Nurse Practitioner CurrentSince Mar 1, 2012 Accepting new patients
Foucher Emergency Group LLC Nurse Practitioner CurrentSince Aug 15, 2013 Accepting new patients

Locations

180 W Esplanade Ave
Kenner, LA 70065
Phone (504) 464-8284

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

Organizations & group practices 3

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": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1295003267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPALCO BLVD",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567336",
            "telephone_number": "504-393-4376",
            "fax_number": "504-930-4307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 LAPALCO BLVD",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700567336",
            "telephone_number": "504-393-4376",
            "fax_number": "504-930-4307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISKUPOVICH",
        "first_name": "TRACI",
        "middle_name": "BOLSTER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.