Traci Renzulli, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.16811-NP Issued in OH

Practice address

1001 Lakeside Ave E
Suite 1000
Cleveland, OH 44114-1158

Phone

(216) 533-3614

Fax

(844) 388-2245

NPI assigned

Dec 11, 2014

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Viaquest Psychiatric and Behavioral Solutions LLCGroup PAC ID 1153358486, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Viaquest Psychiatric & Behavioral Solutions LLC

  • Community/Behavioral Health Agency
  • Dublin, OH
  • NPI 1942451216
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1649678343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVE E",
            "address_2": "SUITE 1000",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441141158",
            "telephone_number": "216-533-3614",
            "fax_number": "844-388-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVE E",
            "address_2": "SUITE 1000",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441141158",
            "telephone_number": "216-533-3614",
            "fax_number": "844-388-2245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZULLI",
        "first_name": "TRACI",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.16811-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Reno, PHARMD
• Renovare Counseling and Consulting LLC
• Mary R Rensel, MD
• Aaron Rentrope
• Donald James Renuart, M.D.
• Kelly M Repas, LPCC
• Dennis Benjamin Repenning, M.D.
• Kerry T Repic
• Nancy Repko
• Justin Resendes, DO

• Family Nurse Practitioner in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.