TRACIE DALENE UPDIKE (M.D.) – Family Medicine Physician, NPI 1629070750

TRACIE DALENE UPDIKE (M.D.) is a healthcare provider. based in Port arthur, Texas. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. J4577 (TX). The NPI Number for TRACIE DALENE UPDIKE (M.D.) is 1629070750

Main info

Female
Sole Proprietor
34 Years Of Experience
Accepts Medicare Assignment
Name
TRACIE DALENE UPDIKE (M.D.)
NPI
1629070750
Phone
(409) 983-1899
Address
2933 PARK PLAZA LN
Enumeration Date
1 June 2005
Last Update Date
12 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4099831899
Graduation Year
1992 (34 years ago)
PAC ID
4183766348
Professional Enrollment ID
I20100126000656
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:21State licenses:1Digital endpointsOther names

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Provider Addresses for TRACIE DALENE UPDIKE (M.D.)

  • Park Plaza Lane, Port Arthur, Jefferson County, Texas, 77642, United States

    PORT ARTHUR, TX 776425516

    Phone: (409) 983-1899

    Fax: (409) 983-5225

    Mailing address matches the actual address.

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: 2010-01-26

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
I20100126000656IFamily PracticeTXTBD

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 77642)

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Reviews

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Frequently asked questions

What identifier follows TRACIE DALENE UPDIKE (M.D.) across health systems?
The NPI 1629070750 uniquely identifies TRACIE DALENE UPDIKE (M.D.) in U.S. healthcare data.
Is TRACIE DALENE UPDIKE (M.D.) currently accepting referrals based on NPI status?
Registry metadata lists TRACIE DALENE UPDIKE (M.D.) as active.
What services align with TRACIE DALENE UPDIKE (M.D.)'s listing?
TRACIE DALENE UPDIKE (M.D.)'s public classification highlights Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Which community is linked to TRACIE DALENE UPDIKE (M.D.)?
TRACIE DALENE UPDIKE (M.D.) shows a connection to Port Arthur, Texas in registry-derived data.
Can I export TRACIE DALENE UPDIKE (M.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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