LUANN MARIE TRACEY (FNP) – Family Nurse Practitioner, NPI 1528358405

LUANN MARIE TRACEY (FNP) is a healthcare provider. based in South bend, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 71003603A (IN). The NPI Number for LUANN MARIE TRACEY (FNP) is 1528358405

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
LUANN MARIE TRACEY (FNP)
NPI
1528358405
Phone
(574) 647-1610
Address
710 N NILES AVE
Enumeration Date
13 April 2011
Last Update Date
16 June 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2694453874
Graduation Year
2010 (16 years ago)
PAC ID
3779761135
Group Practice PAC ID
2264423771
Professional Enrollment ID
I20190515001970
Address ID
MI490311034CA261XXMXXX202
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

8,192 NURSE PRACTITIONER in IN

Provider Addresses for LUANN MARIE TRACEY (FNP)

  • 710 N NILES AVE

    SOUTH BEND, IN 466171924

    Phone: (574) 647-1610

    Fax: (574) 237-6069

    Type: Mailing

  • 1708 HIGH ST

    SOUTH BEND, IN 466132633

    Phone: (574) 647-1400

    Fax: (574) 647-5128

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-05-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190515001970INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46617)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2264423771View full group profile
NameSpecialtyState
Mental Health CounselorMI
Physician AssistantMI
Clinical Social WorkerMI
Family PracticeMI
Family PracticeMD
Family PracticeMI
Physician AssistantPA
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

What is the registry number for LUANN MARIE TRACEY (FNP)?
The registry entry for LUANN MARIE TRACEY (FNP) shows NPI 1528358405.
Should I treat LUANN MARIE TRACEY (FNP) as an active provider?
Patients and plans typically see LUANN MARIE TRACEY (FNP) as active in the national extract.
What does the directory say LUANN MARIE TRACEY (FNP) does?
Insurance directories may phrase it differently, but here LUANN MARIE TRACEY (FNP) maps to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What city is tied to LUANN MARIE TRACEY (FNP)?
The directory associates LUANN MARIE TRACEY (FNP) with South Bend, Indiana. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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