Traci Renee Pulliam, DNP in South Bend, IN - Medicare Nurse Practitioner

Traci Renee Pulliam, DNP is a medicare enrolled "Nurse Practitioner - Family" in South Bend, Indiana. Her current practice location is 615 N Michigan St Fl 4, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 647-6892.

Traci Renee Pulliam is licensed to practice in Indiana (license number 71007505A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023533890.

Contact Information

	Traci Renee Pulliam, DNP
	615 N Michigan St Fl 4, South Bend, IN 46601-1033
	(574) 647-6892
	(574) 647-6895

Map and Direction

Provider's Profile

Full Name	Traci Renee Pulliam
Gender	Female
Speciality	Nurse Practitioner - Family
Location	615 N Michigan St Fl 4, South Bend, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1023533890
Provider Enumeration Date: 08/13/2017
Last Update Date: 03/31/2021

Medicare PECOS Information:

PECOS PAC ID: 9739445081
Enrollment ID: I20171102001785

Medical Identifiers

Medical identifiers for Traci Renee Pulliam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1023533890	NPI	-	NPPES
300007557	Medicaid	IN
259900012	Other	IN	MEDICARE PTAN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	71007505A (Indiana)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Traci Renee Pulliam allows following entities to bill medicare on her behalf.

Entity Name	Beacon Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Traci Renee Pulliam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Traci Renee Pulliam, DNP 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610	Traci Renee Pulliam, DNP 615 N Michigan St Fl 4, South Bend, IN 46601-1033 Ph: (574) 647-6892

Reviews and Comments

Nurse Practitioner Nurses in South Bend, IN

Beth Ann Hayden, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 707 N Michigan St, Ste 400, South Bend, IN 46601 Phone: 574-647-8470 Fax: 574-647-8475
Rachel Ann Jennings, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000
Kelly Mae Losiniecki, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 211 N Eddy St., South Bend, IN 46617 Phone: 574-237-9231 Fax: 574-204-6355
Mrs. Brandice Lynn Page, APNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 53760 Generations Dr, South Bend, IN 46635 Phone: 888-938-3838 Fax: 888-919-1083
Gina M. Connolly, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Navarre Pl Ste 6600, South Bend, IN 46601 Phone: 574-647-8800 Fax: 574-647-8811
Amanda Lundberg, MSN, RN, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 53830 Generations Dr Ste 110, South Bend, IN 46635 Phone: 574-234-2191
Kendall Hochstedler, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1960 Northside Blvd, South Bend, IN 46615 Phone: 574-307-7673 Fax: 574-234-4706

Traci Renee Pulliam, DNP - Medicare Nurse Practitioner in South Bend, IN