Individual provider Active NPI

Traci M Morgan, PA-C

  • Medical Physician Assistant
  • San Diego, CA
National Provider Identifier
1518955574
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
16226 Issued in CA
Practice address
7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411
Phone
(619) 325-1161
Fax
(619) 325-1717
NPI assigned
Oct 12, 2005
Last updated
Oct 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 16226 CA Primary

Addresses

Primary practice location

7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411

Mailing address

7525 Metropolitan Dr
Suite 302
San Diego, CA 92108-4411
Phone (619) 325-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111214001082 CA Practitioner - Physician Assistant 4486829751 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16226CAMDProfessional Counselor

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1518955574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR",
            "address_2": "SUITE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084411",
            "telephone_number": "619-325-1161",
            "fax_number": "619-325-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 METROPOLITAN DR",
            "address_2": "SUITE 302",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084411",
            "telephone_number": "619-325-1161",
            "fax_number": "619-325-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "TRACI",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "16226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.