Tracie Dalene Updike, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

J4577 Issued in TX

Practice address

2933 Park Plaza LN
Port Arthur, TX 77642-5516

Phone

(409) 983-1899

Fax

(409) 983-5225

NPI assigned

Jun 1, 2005

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Complete Health Care

  • Family Nurse Practitioner
  • Port Arthur, TX
  • NPI 1316610017
  NPD (past)
• Ukanti Healthcare Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Arthur, TX
  • NPI 1114769023
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1629070750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 PARK PLAZA LN",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776425516",
            "telephone_number": "409-983-1899",
            "fax_number": "409-983-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 PARK PLAZA LN",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776425516",
            "telephone_number": "409-983-1899",
            "fax_number": "409-983-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPDIKE",
        "first_name": "TRACIE",
        "middle_name": "DALENE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J4577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136424202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Twin City Dental, PA
• Tyler County Hospital District (Bonne Vie)
• Ukanti Healthcare Services PLLC
• Landry Kalombo Umbu, MD
• Connie Ung, O.D.
• Ifeoma Uwagboe, RPH
• Mohamed Dawood Vadva, MD
• Monique Nichole Vannoy, FNP
• Maura Vazquez, LVN
• Caitlin Joy Veazey, FNP-C

• Family Medicine Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.