Tracy Diane Tullier, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0005195 Issued in MD

Practice address

6934 Aviation Blvd
Suite B
Glen Burnie, MD 21061-2593

Phone

(443) 949-0814

NPI assigned

Sep 26, 2013

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 MD

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

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mdics at Anne Arundel LLCGroup PAC ID 1456515519, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Luminis Health Anne Arundel Medical Center, Inc Hospital, Annapolis, MD, CCN 210023

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mdics at Anne Arundel LLC

  • Hospitalist Physician
  • Annapolis, MD
  • NPI 1427343664
  Medicare reassignment Care Compare group

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

• Luminis Health Anne Arundel Medical Center, Inc.

  • Clinical Medical Laboratory
  • Annapolis, MD
  • NPI 1356885032

  Hospital

  Care Compare affiliation
• Luminis Health Anne Arundel Medical Center, Inc.

  • General Acute Care Hospital
  • Annapolis, MD
  • NPI 1477517225
  Care Compare affiliation

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1972939692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD",
            "address_2": "SUITE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "443-949-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD",
            "address_2": "SUITE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "443-949-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIER",
        "first_name": "TRACY",
        "middle_name": "DIANE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0005195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayne Trouwborst
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• Sarah Li Tsai, FNP-BC, FNP-C
• Demetri Tsiolkas
• Ashley Ka Yan Tsu, CRNP-PMH
• Dayonna Tunstall, RBT
• Kamalakar Tunuguntla
• Judy Turner, LGPC, NCC
• Shauntae Turner
• Teresa Turner, MS RD LDN SNS FAND

• Medical Physician Assistant in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.