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DR. PATRICK LACKMANN TRAYNOR RD
NPI 1477236347
Dietitian, Registered in South Lake Tahoe, CA

Active since August 08, 2023
3079 HARRISON AVE, SOUTH LAKE TAHOE, CA 96150(909) 653-3471(949) 269-0134 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Patrick Lackmann Traynor Rd NPPES

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

DR. PATRICK LACKMANN TRAYNOR RD (NPI 1477236347) is an individual dietitian, registered in South Lake Tahoe, California, licensed in California (86082088) and active in the NPI registry since August 2023.

NPPES Registry Identity

NPI1477236347
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameDR. PATRICK LACKMANN TRAYNORCredential: RD
Location Address3079 HARRISON AVESouth Lake Tahoe, CA 96150
Mailing Address671 River Ranch RoadMarkleeville, CA 96120 · (909) 653-3471 · Fax (949) 269-0134
Phone(909) 653-3471
Fax(949) 269-0134
Sole ProprietorNo
Enumeration DateAugust 8, 2023
NPPES CertifiedAugust 8, 2023
✔ NPI 1477236347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
License✔ Licensed in CA · 86082088
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
3079 HARRISON AVE, South Lake Tahoe, CA 96150
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Oregon.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Patrick Lackmann Traynor Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Patrick Traynor reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mnt Scientific
Same address
Dietitian, Registered
3079 HARRISON AVE
South Lake Tahoe, CA 96150
  • Reassigned Medicare billing, California enrollment
NPI 1588347462 (909) 653-3471

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

Other Providers at the Same Location NPPES 5

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

MS. ANDREA DAWN CARSONER-LANDRY
Behavior Technician
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 578-3839
SHANE DAVID NIBLEY
Rehabilitation Practitioner
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 957-6254
MNT SCIENTIFIC
Dietitian, Registered
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (909) 653-3471
REBECCA RENEE ROJAS
Case Manager/Care Coordinator
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (510) 247-8300
JERAMY DANTZLER
Health Educator
3079 HARRISON AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 721-6920

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 Patrick Traynor's NPI number?

The NPI number for Patrick Traynor is 1477236347. It was assigned to this individual provider in the NPPES registry on August 8, 2023.

Where is Patrick Traynor located?

Patrick Traynor practices at 3079 Harrison Ave, South Lake Tahoe, CA 96150. The listed phone number is (909) 653-3471.

What is Patrick Traynor's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Patrick Traynor enrolled in Medicare?

Yes. Patrick Traynor is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Patrick Traynor's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Patrick Traynor reassigns Medicare benefits to Mnt Scientific (South Lake Tahoe, CA). 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 Patrick Traynor's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Patrick Traynor accept?

Health plans from BridgeSpan Health Company and Regence BlueCross BlueShield of Oregon list Patrick Traynor 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 Patrick Traynor was last updated on August 8, 2023. 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.