TRACI MANCUSO (APRN) – Emergency Medicine Physician, NPI 1619069226
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,261 NURSE PRACTITIONER in WA
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Provider Addresses for TRACI MANCUSO (APRN)
post box, 74th Street West, Wispering Pines, Lakewood, Pierce County, Washington, 98499-8398, United States
LAKEWOOD, WA 984968886
Phone: (253) 589-6573
Fax: (253) 984-1079
Type: Mailing
4901, 108th Street Southwest, Bridgeport Way Apartments, Lakeview, Lakewood, Pierce County, Washington, 98499, United States
LAKEWOOD, WA 984993724
Phone: (253) 589-6573
Fax: (256) 984-1079
Type: Location
4425 E VILLA CASSANDRA WAY
CAVE CREEK, AZ 853319564
Phone: (206) 755-6699
Fax: (480) 847-2271
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: 2024-02-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20230825002749 | I | Nurse Practitioner | AZ | TBD |
| I20240209001446 | I | Nurse Practitioner | NV | TBD |
| I20240221004004 | I | Nurse Practitioner | FL | 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 98496)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Physician Assistant | NV | |
| Nurse Practitioner | NV | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | NV | |
| Nurse Practitioner | AZ | |
| Physician Assistant | NV | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | NV |
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