LISA TRACY ANN BRYAN UKAWUILULU APRN
NPI 1316416076
Nurse Practitioner in Daytona Beach, FL

Q: What is Lisa Tracy Ann Bryan Ukawuilulu's NPI number?

The NPI number for Lisa Tracy Ann Bryan Ukawuilulu is 1316416076. It was assigned to this individual provider in the NPPES registry on November 23, 2018.

Q: What is Lisa Tracy Ann Bryan Ukawuilulu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since November 23, 2018PECOS Enrolled

405 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114(386) 506-8555 Get Directions Write a Review

NPPES record last updated: November 23, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Lisa Tracy Ann Bryan Ukawuilulu Aprn NPPES

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

LISA TRACY ANN BRYAN UKAWUILULU APRN (NPI 1316416076) is an individual nurse practitioner in Daytona Beach, Florida, licensed in Florida (9282094) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316416076

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameLISA TRACY ANN BRYAN UKAWUILULUCredential: APRN

Location Address405 N CLYDE MORRIS BLVDDaytona Beach, FL 32114-2730

Mailing Address5418 Fan Palm CtPort Orange, FL 32128-7447 · (386) 214-5004

Phone(386) 506-8555

Sole ProprietorNo

Enumeration DateNovember 23, 2018

✔ NPI 1316416076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · 9282094

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

405 N CLYDE MORRIS BLVD, Daytona Beach, FL 32114

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Tracy Ann Bryan Ukawuilulu Aprn 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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Tracy Ann Bryan Ukawuilulu reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Halifax Healthcare Systems Inc

0.4 mi

Family Medicine

303 N CLYDE MORRIS BLVD
Daytona Beach, FL 32114

Reassigned Medicare billing, Florida enrollment
786 clinicians in this Medicare group

NPI 1245283530 (386) 254-4000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32114 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$99.16 typical visit price

range $17.57 – $139.16

Typical copayment $24.79 (range $4.39 – $34.79)

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 3

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

EJAZ AHMED MD

Family Medicine

405 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114

Volusia County (386) 506-8555

KENNETH J LUCAS MD

Family Medicine

405 N CLYDE MORRIS BLVD, 405 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114

Volusia County (386) 257-1626

SENIOR HEALTH CARE OF VOLUSIA

Family Medicine (Adult Medicine)

405 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114

Volusia County (386) 257-1626

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 Lisa Tracy Ann Bryan Ukawuilulu's NPI number?

The NPI number for Lisa Tracy Ann Bryan Ukawuilulu is 1316416076. It was assigned to this individual provider in the NPPES registry on November 23, 2018.

Where is Lisa Tracy Ann Bryan Ukawuilulu located?

Lisa Tracy Ann Bryan Ukawuilulu practices at 405 N Clyde Morris Blvd, Daytona Beach, FL 32114. The listed phone number is (386) 506-8555.

What is Lisa Tracy Ann Bryan Ukawuilulu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Lisa Tracy Ann Bryan Ukawuilulu enrolled in Medicare?

Yes. Lisa Tracy Ann Bryan Ukawuilulu is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Tracy Ann Bryan Ukawuilulu's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Tracy Ann Bryan Ukawuilulu reassigns Medicare benefits to Halifax Healthcare Systems Inc (Daytona Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Tracy Ann Bryan Ukawuilulu's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lisa Tracy Ann Bryan Ukawuilulu was last updated on November 23, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.