TRACI RENEE PULLIAM DNP
NPI 1023533890
Nurse Practitioner - Family in South Bend, IN

Q: What is Traci Pulliam's NPI number?

The NPI number for Traci Pulliam is 1023533890. It was assigned to this individual provider in the NPPES registry on August 13, 2017.

Q: What is Traci Pulliam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Traci Pulliam was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 13, 2017PECOS Enrolled

615 N MICHIGAN ST FL 4, SOUTH BEND, IN 46601(574) 647-6892(574) 647-6895 Get Directions Write a Review

NPPES record last updated: March 31, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Mar 31, 2021, Nov 6, 2017, Oct 26, 2017 and 1 more (4 updates tracked since 2017).

On this page

About Traci Renee Pulliam Dnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRACI RENEE PULLIAM DNP (NPI 1023533890) is an individual family provider in South Bend, Indiana, licensed in Indiana (71007505A) and active in the NPI registry since August 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023533890

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTRACI RENEE PULLIAMCredential: DNP

Location Address615 N MICHIGAN ST FL 4South Bend, IN 46601-1033

Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069

Phone(574) 647-6892

Fax(574) 647-6895

Sole ProprietorNo

Enumeration DateAugust 13, 2017

Last NPPES UpdateMarch 31, 20214 updates tracked since enumeration

NPPES CertifiedMarch 31, 2021

✔ NPI 1023533890 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IN · 71007505A

615 N MICHIGAN ST FL 4, South Bend, IN 46601

Open in Google Maps ↗

Other Identifiers 2

Other259900012IN · Medicare Ptan

Medicaid300007557IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Traci Renee Pulliam Dnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.04 typical visit price

range $53.07 – $161.76

Typical copayment $20.51 (range $13.26 – $40.44)

Most-billed visit code 99203

Established Patient

$94.22 typical visit price

range $16.93 – $132.22

Typical copayment $23.55 (range $4.23 – $33.05)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACK STADDON M.D., PH.D.

Pediatrics (Pediatric Hematology-Oncology)

615 N MICHIGAN ST FL 4
SOUTH BEND, IN 46601

St. Joseph County (574) 647-6892

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Traci Pulliam's NPI number?

The NPI number for Traci Pulliam is 1023533890. It was assigned to this individual provider in the NPPES registry on August 13, 2017.

Where is Traci Pulliam located?

Traci Pulliam practices at 615 N Michigan St Fl 4, South Bend, IN 46601. The listed phone number is (574) 647-6892.

What is Traci Pulliam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Traci Pulliam enrolled in Medicare?

Yes. Traci Pulliam is registered in the Medicare PECOS enrollment system.

What insurance does Traci Pulliam accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Traci Pulliam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Traci Pulliam was last updated on March 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.