Individual provider Active NPI

Michaila Marie Traceski, PA

  • Physician Assistant
  • Stamford, CT
National Provider Identifier
1356077135
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9390 Issued in MA
Practice address
1180 Newfield Ave
Stamford, CT 06905-1409
Phone
(314) 888-5233
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2034 NH
Physician Assistant 363A00000X PA9390 MA Primary

Addresses

Primary practice location

1180 Newfield Ave
Stamford, CT 06905-1409

Mailing address

339 Main St # 1B
Nashua, NH 03060-4663
Phone (508) 768-5473

Other practice location 1

62 Brown St Ste 303
Haverhill, MA 01830-6790
Phone (978) 794-1946

Other practice location 2

16 Pelham Rd Ste 1
Salem, NH 03079-3077
Phone (978) 794-1946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, CT3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20230615000952 MA Practitioner - Physician Assistant 3375901895 Reassigns benefits to 4 organizations
I20230621001364 NH Practitioner - Physician Assistant 3375901895 Reassigns benefits to 4 organizations
I20241002001454 CT Practitioner - Physician Assistant 3375901895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

380 John Fitch Hwy
Fitchburg, MA 01420-4502
Phone (978) 696-3547

757 Boston Post Rd E
Marlborough, MA 01752-3704
Phone (508) 630-8989

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.33 of 100Reported as group
Quality
45.66
Promoting interoperability
100
Improvement activities
40
Cost
68.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6516CTMDPediatric Occupational Therapist
PA9390MAMDPhysician Assistant
2034NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clearchoicemd, PLLC CurrentSince Jul 11, 2024 Accepting new patients
Eone Medical PLLC CurrentSince May 1, 2023 Accepting new patients
Eone Medical Subsidiary PLLC CurrentSince May 9, 2023 Accepting new patients
Urgent Care Centers of Central Massachusetts, LLC CurrentSince Jul 11, 2024 Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

62 Brown St
Ste 303
Haverhill, MA 01830
Phone (978) 556-9060

757 Boston Post Rd E
Marlborough, MA 01752
Phone (508) 630-8989

575 Turnpike St
Ste 11
North Andover, MA 01845
Phone (978) 327-6561

410 Miracle Mile
Lebanon, NH 03766
Phone (603) 276-3260

16 Pelham Rd
Ste 1
Salem, NH 03079
Phone (603) 898-2244

Organizations & group practices 11

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 2

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1356077135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 MAIN ST # 1B",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030604663",
            "telephone_number": "508-768-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 NEWFIELD AVE",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069051409",
            "telephone_number": "314-888-5233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Brown St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Haverhill",
            "state": "MA",
            "postal_code": "018306790",
            "country_code": "US",
            "telephone_number": "978-794-1946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Pelham Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "NH",
            "postal_code": "030793077",
            "country_code": "US",
            "telephone_number": "978-794-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRACESKI",
        "first_name": "MICHAILA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "2034",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.