TRACI C BOULLION AGNP-C
NPI 1568096279
Hospitalist in Daytona Beach, FL

Q: What is Traci Boullion's NPI number?

The NPI number for Traci Boullion is 1568096279. It was assigned to this individual provider in the NPPES registry on March 3, 2020.

Q: What is Traci Boullion's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Q: When was this NPI record last updated?

The NPPES record for Traci Boullion was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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 March 03, 2020PECOS EnrolledAccepts Medicare Assignment

92.93/100

CMS Quality Rating

311 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114(386) 241-1020(386) 241-1022 Get Directions Write a Review

NPPES record last updated: April 20, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 20, 2026, Nov 14, 2024, Jun 1, 2021 and 1 more (4 updates tracked since 2020).

On this page

About Traci C Boullion Agnp-c NPPES

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

TRACI C BOULLION AGNP-C (NPI 1568096279) is an individual hospitalist provider in Daytona Beach, Florida, licensed in Florida (APRN11034876) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1568096279

Entity TypeIndividualFemale

Primary Taxonomy208M00000X

Provider Legal NameTRACI C BOULLIONCredential: AGNP-C

Location Address311 N CLYDE MORRIS BLVDDaytona Beach, FL 32114-2781

Mailing Address311 N Clyde Morris BlvdDaytona Beach, FL 32114-2781 · (386) 241-1020 · Fax (386) 241-1022

Phone(386) 241-1020

Fax(386) 241-1022

Sole ProprietorYes

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 3, 2020

Last NPPES UpdateApril 20, 20264 updates tracked since enumeration

NPPES CertifiedApril 20, 2026

✔ NPI 1568096279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians

Taxonomy Code208M00000X

License✔ Licensed in FL · APRN11034876

Definition

Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.

Also ListedNurse PractitionerTaxonomy 363L00000X · License RN196865 (GA), AG02200003 (TX)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License APRN11034876 (FL)

311 N CLYDE MORRIS BLVD, Daytona Beach, FL 32114

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Secondary Practice Locations 2

Location 1127 Santolina ParkPeachtree City, GA 30269-3245 · Phone (564) 389-8282

Location 255 Whitcher St NE Ste 130Marietta, GA 30060-1156 · Phone (770) 428-0462 · Fax (770) 427-8001

Other Identifiers 1

Medicaid124409700FL

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

Traci C Boullion Agnp-c 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 ID2466869771

PECOS Enrollment IDI20241205004247

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 Reassignments

Medicare enrollment records show Traci Boullion reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Vip Specialties Of Florida

78 mi

Hospitalist

13715 RICHMOND PARK DR N UNIT 401
Jacksonville, FL 32224

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

NPI 1790499812 (410) 258-6500

Florida Clinical Practice Association Inc

83 mi

Surgery

1600 SW ARCHER RD
Gainesville, FL 32610

Reassigned Medicare billing, Florida enrollment
3,324 clinicians in this Medicare group

NPI 1063463768 (352) 265-7922

Wellstar Medical Group, LLC

369 mi

Internal Medicine

3885 PRINCETON LAKES WAY SW, SUITE 300
Atlanta, GA 30331

Reassigned Medicare billing, Georgia enrollment
3,885 clinicians in this Medicare group

NPI 1205267192 (404) 344-0059

Acute Care Surgery Medical Group, Inc.

2,390 mi

Surgery

2801 K STREET SUITE 440
Sacramento, CA 95816

Reassigned Medicare billing, Georgia enrollment
37 clinicians in this Medicare group

NPI 1700069549 (916) 441-0400

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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.38

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

MR. J PATRICK KERR CRNA

Nurse Anesthetist, Certified Registered

311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114

Volusia County (386) 255-1266

DR. BENNETT PETER SCAGLIA M.D.

Urology

311 N CLYDE MORRIS BLVD, SUITE 360
DAYTONA BEACH, FL 32114

Volusia County (386) 254-4199

MS. KIMBERLY KAY KOEVENIG RD, LD/N, CDE

Dietitian, Registered

311 N CLYDE MORRIS BLVD, SUITE 440-OUTPATIENT DIABETES EDUCATION, HALIFAX HEALTH
DAYTONA BEACH, FL 32114

Volusia County (386) 258-4829

HALIFAX HEALTHCARE SYSTEMS, INC

Neurological Surgery

311 N CLYDE MORRIS BLVD, SUITE 550
DAYTONA BEACH, FL 32114

Volusia County (386) 254-4000

CLAYTON T SAXOUR CRNA

Nurse Anesthetist, Certified Registered

311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114

Volusia County (386) 255-1266

PATRICIA GONZALEZ

Nurse Anesthetist, Certified Registered

311 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114

Volusia County (386) 254-4000

BRENDA L. HART FNP-C, CRNP, CWON

Nurse Practitioner (Family)

311 N CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114

Volusia County (386) 425-4267

DAVID SCHULTZ DO

Anesthesiology

311 N CLYDE MORRIS BLVD, SUITE 350
DAYTONA BEACH, FL 32114

Volusia County (386) 255-1266

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 Boullion's NPI number?

The NPI number for Traci Boullion is 1568096279. It was assigned to this individual provider in the NPPES registry on March 3, 2020.

Where is Traci Boullion located?

Traci Boullion practices at 311 N Clyde Morris Blvd, Daytona Beach, FL 32114. The listed phone number is (386) 241-1020.

What is Traci Boullion's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Traci Boullion enrolled in Medicare?

Yes. Traci Boullion 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 organizations bill Medicare for Traci Boullion's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Traci Boullion reassigns Medicare benefits to 4 organizations: Vip Specialties Of Florida (Jacksonville, FL), Florida Clinical Practice Association Inc (Gainesville, FL), Wellstar Medical Group, LLC (Atlanta, GA) and Acute Care Surgery Medical Group, Inc. (Sacramento, CA). Each 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 Boullion'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 Boullion was last updated on April 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.