TRACIE BARETELA (PA) – Physician Assistant, NPI 1699734335
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,684 PHYSICIAN ASSISTANT in AZ
Provider Addresses for TRACIE BARETELA (PA)
5349 W CANARY GRASS WAY
SOUTH JORDAN, UT 840091399
Phone: (360) 689-6397
Type: Mailing
HC 63 BOX 9000
DILKON, AZ 860479477
Phone: (928) 657-1000
Fax: (928) 289-6229
Type: Location
St. Michael Medical Center Bremerton, 2520, Cherry Avenue, Bremerton, Kitsap County, Washington, 98310, United States
BREMERTON, WA 983104229
Phone: (360) 744-4949
Type: Location
Bartlett Court, Silverdale, Kitsap County, Washington, 98393, United States
SILVERDALE, WA 983838931
Phone: (360) 689-6397
Type: Mailing
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: 2025-04-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050519000507 | I | Physician Assistant | UT | TBD |
| I20060504000381 | I | Physician Assistant | WA | TBD |
| I20241120004456 | I | Physician Assistant | AZ | TBD |
| I20250423000881 | I | Physician Assistant | TX | TBD |
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.
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 84009)
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