Active NPI
Michele K. Trazkovich, M.D.
- Psychiatry Physician
- Reisterstown, MD
National Provider Identifier
1881815603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- D0035400
- Practice address
- 17 Sunday CT.
Reisterstown, MD 21136-6111 - Phone
- (410) 526-2809
- Fax
- (410) 526-2809
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Psychiatry & Neurology) Physician | 2084H0002X | D0035400 | MD | |
| Psychiatry Physician | 2084P0800X | D0035400 | MD | Primary |
Addresses
Primary practice location
17 Sunday CT.
Reisterstown, MD 21136-6111
Mailing address
17 Sunday CT.
Reisterstown, MD 21136-6111
Phone (410) 526-2809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9212 MK | Other | MD | BLUE CROSS BLUE SHIELD |
Other names 1
- Dr. Shelley K. Trazkovich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 27, 2015 through Aug 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0035400 | MD | MD | Hospice and Palliative Medicine (Psychiatry & Neurology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1881815603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 SUNDAY CT.",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "211366111",
"telephone_number": "410-526-2809",
"fax_number": "410-526-2809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 SUNDAY CT.",
"city": "REISTERSTOWN",
"state": "MD",
"postal_code": "211366111",
"telephone_number": "410-526-2809",
"fax_number": "410-526-2809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAZKOVICH",
"first_name": "MICHELE",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084H0002X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Hospice and Palliative Medicine",
"state": "MD",
"license": "D0035400",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0035400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "9212 MK",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "TRAZKOVICH",
"middle_name": "K.",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Reisterstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.