Tracie Baretela, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9887 Issued in AZ

Practice address

HC 63 Box 9000
Dilkon, AZ 86047-9477

Phone

(928) 657-1000

Fax

(928) 289-6229

NPI assigned

Mar 21, 2006

Last updated

Nov 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, WA, AZ, TX, NM5 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 5

Specialty

Physician Assistant

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Exceptional Community Hospital Bullhead City Hospital, Bullhead City, AZ, CCN 030155

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Exceptional Physicians Group Bullhead City Hospital PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bullhead City, AZ
  • NPI 1518732023
  Medicare reassignment NPD
• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352
  Medicare reassignment NPD (past)
• DHHS PHS Naihs Chinle Comprehensive Health Care Facility

  dba Chinle Comprehensive Health Care Facility

  • General Acute Care Hospital
  • Chinle, AZ
  • NPI 1508800129

  TX

  Medicare reassignment
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment
• Cep America LLC

  dba Vituity

  • Emergency Medicine Physician
  • Edmonds, WA
  • NPI 1447484274
  Medicare reassignment
• Grant County Public Hospital District 1

  dba Samaritan Clinic

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment
• Hospitalist Medicine Physicians of New Mexico - Clovis, LLC

  • Emergency Medicine Physician
  • Hobbs, NM
  • NPI 1477031094
  Medicare reassignment
• Innova Emergency Medical Associates PC

  • Emergency Medicine Physician
  • Trinidad, CO
  • NPI 1295178978

  AZ

  Medicare reassignment
• Tacoma Emergency Care Physicians, PLLC

  • Emergency Medicine Physician
  • Tacoma, WA
  • NPI 1770823791
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Exceptional Health Care Bullhead City LLC

  dba Exceptional Community Hospital Bullhead City

  • Special Hospital
  • Bullhead City, AZ
  • NPI 1750092110
  Care Compare affiliation

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1699734335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 W CANARY GRASS WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840091399",
            "telephone_number": "360-689-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 63 BOX 9000",
            "city": "DILKON",
            "state": "AZ",
            "postal_code": "860479477",
            "telephone_number": "928-657-1000",
            "fax_number": "928-289-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARETELA",
        "first_name": "TRACIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "PA10005007",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005007",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Crowder
• Janell K Dickson, LPC
• Dilkon Medical Center
• Dilkon Medical Center Pharmacy
• Hozho Wellness PLLC (Hozho Wound Care & Limb Preservation Clinic)

• Physician Assistant in Dilkon, AZ
• Providers in Dilkon, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; 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.