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DR. TRACI M BOLOGNA-JILL DPM
NPI 1346746062
Podiatrist - Foot & Ankle Surgery in Providence, RI

Active since April 02, 2018PECOS EnrolledAccepts Medicare Assignment
1 RANDALL SQ STE 408, PROVIDENCE, RI 02904(401) 453-2000(401) 253-2002 Get Directions Write a Review

NPPES record last updated: December 15, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 15, 2022, Jun 27, 2021, Apr 1, 2021 (3 updates tracked since 2021).

About Dr. Traci M Bologna-jill Dpm NPPES

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

DR. TRACI M BOLOGNA-JILL DPM (NPI 1346746062) is an individual foot & ankle surgery provider in Providence, Rhode Island, licensed in Rhode Island (DPM00367) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS and is a graduate of New York College Of Podiatric Medicine (2018).

NPPES Registry Identity

NPI1346746062
Entity TypeIndividualFemale
Primary Taxonomy213ES0103X
Provider Legal NameDR. TRACI M BOLOGNA-JILLCredential: DPM
Location Address1 RANDALL SQ STE 408Providence, RI 02904-7405
Mailing Address1 Randall Sq Ste 408Providence, RI 02904-7405 · (401) 453-2000 · Fax (401) 253-2002
Phone(401) 453-2000
Fax(401) 253-2002
Sole ProprietorNo
Medical School CMSNew York College Of Podiatric MedicineGraduated 2018
Enumeration DateApril 2, 2018
Last NPPES UpdateDecember 15, 20223 updates tracked since enumeration
NPPES CertifiedDecember 15, 2022
✔ NPI 1346746062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License✔ Licensed in RI · DPM00367
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1 RANDALL SQ STE 408, Providence, RI 02904
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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 and accepts Medicare assignment

Dr. Traci M Bologna-jill Dpm is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648672808
PECOS Enrollment IDI20210709001948
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 Traci Bologna-jill reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lepoer Podiatry, Inc.
10 mi
Clinic/Center
1 RANDALL SQ STE 408
Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 2 clinicians in this Medicare group
NPI 1871123372 (401) 453-2000

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

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
106 services39 patients
Trimming of dystrophic nails, any number G0127
Trimming of dystrophic nails involves the careful cutting and shaping of thickened or deformed nails. This is often required when nails are affected by conditions such as fungus or psoriasis. The procedure helps to reduce discomfort and improve nail health.
47 services18 patients
Removal of noncancer thickened skin growth, 1 growth 11055
This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.
36 services16 patients
Removal of noncancer thickened skin growth, 2-4 growths 11056
This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.
32 services18 patients
Removal of fingernails or toenails, 6 or more nails 11721
This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.
26 services12 patients
Trimming of fingernails or toenails 11719
Trimming of fingernails or toenails is a simple procedure for maintaining hygiene and preventing nail-related issues. It involves cutting the nails straight across, then smoothing any sharp edges with a file. Regular nail care can help prevent infections and discomfort.
22 services13 patients

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.

LEPOER PODIATRY, INC.
Durable Medical Equipment & Medical Supplies
1 RANDALL SQ STE 408
PROVIDENCE, RI 02904
Providence County (401) 453-2000
KRYSIA L LEPOER DPM
Podiatrist (Foot & Ankle Surgery)
1 RANDALL SQ STE 408
PROVIDENCE, RI 02904
Providence County (401) 453-2000
LEPOER PODIATRY, INC.
Clinic/Center
1 RANDALL SQ STE 408
PROVIDENCE, RI 02904
Providence County (401) 453-2000

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 Bologna-jill's NPI number?

The NPI number for Traci Bologna-jill is 1346746062. It was assigned to this individual provider in the NPPES registry on April 2, 2018.

Where is Traci Bologna-jill located?

Traci Bologna-jill practices at 1 Randall Sq Ste 408, Providence, RI 02904. The listed phone number is (401) 453-2000.

What is Traci Bologna-jill's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Traci Bologna-jill enrolled in Medicare?

Yes. Traci Bologna-jill is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Traci Bologna-jill's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Traci Bologna-jill reassigns Medicare benefits to Lepoer Podiatry, Inc. (Providence, RI). 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 Traci Bologna-jill'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 Traci Bologna-jill was last updated on December 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.