Traci Badeusz Scullin, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

698610 Issued in TX

Practice address

2001 N Jefferson Ave
Mount Pleasant, TX 75455-2371

Phone

(903) 577-6080

NPI assigned

Apr 30, 2010

Last updated

Sep 12, 2012By 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 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Texas Medical Services PLLCGroup PAC ID 5890156541, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• East Texas Medical Services PLLC

  • Emergency Medicine Physician
  • Mount Pleasant, TX
  • NPI 1972292282
  Medicare reassignment Care Compare group NPD
• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611
  Medicare reassignment

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1720305683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7262 FARM ROAD 1734",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754551730",
            "telephone_number": "903-818-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N JEFFERSON AVE",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552371",
            "telephone_number": "903-577-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCULLIN",
        "first_name": "TRACI",
        "middle_name": "BADEUSZ",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "698610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deloris L Schiller, F.N.P.
• Judy K. Schmidt, OTR
• Tonya Renea Schultz, LPC
• Deborah D. Schumacher, SLP
• Laurin C Scoggins, PHARMD
• Milan Sekulic, MD
• Shae Ochoa DDS, Ms, PA
• Mohammad Javeed Shafi, M.D.
• Vandana Mrugesh Shah, MD
• Shahid Dental Group Mt. Pleasant, PLLC (Pleasant Smiles Dental)

• Nurse Practitioner in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.