Individual provider Active NPI

Traci Ann Vopalensky, FNP

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1942855705
Registry record updated Dec 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP221855 Issued in AZ
Practice address
4900 N Scottsdale Rd
Scottsdale, AZ 85251-7652
Phone
(480) 874-5806
Fax
(480) 210-8194
NPI assigned
Aug 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP221855 AZ Primary

Addresses

Primary practice location

4900 N Scottsdale Rd
Scottsdale, AZ 85251-7652

Mailing address

4900 N Scottsdale Rd
Scottsdale, AZ 85251-7652
Phone (480) 874-5806

Other identifiers 1

IdentifierTypeStateIssuer
AP221855OtherAZSTATE OF ARIZONA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20190918002732 AZ Practitioner - Nurse Practitioner 3274863253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP221855AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC CurrentSince Apr 1, 2021 Accepting new patients
4C Medical Group PLC Past Accepting new patients

Locations

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

14418 W Meeker Blvd
Ste 200
Sun City West, AZ 85375
Phone (602) 641-9343

14418 W Meeker Blvd
Ste 100
Sun City West, AZ 85375
Phone (602) 463-4872

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608768000000",
    "number": "1942855705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 N SCOTTSDALE RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517652",
            "telephone_number": "480-874-5806",
            "fax_number": "480-210-8194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 N SCOTTSDALE RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517652",
            "telephone_number": "480-874-5806",
            "fax_number": "480-210-8194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOPALENSKY",
        "first_name": "TRACI ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2020-12-24",
        "certification_date": "2020-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP221855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARIZONA",
            "identifier": "AP221855",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.