NPIMap

Individual provider Active NPI

Eric Brackett, MD

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1003993288
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01049522A Issued in IN
Practice address
711 Saint Marys Dr
Evansville, IN 47714-0508
Phone
(812) 485-5858
NPI assigned
Nov 1, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01049522A IN Primary

Addresses

Primary practice location

711 Saint Marys Dr
Evansville, IN 47714-0508

Mailing address

711 Saint Marys Dr
Evansville, IN 47714-0508

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eric.brackett.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100818000115 IN Practitioner - Family Practice 3072644202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health, IncGroup PAC ID 0547154650, shared by 9 NPIs, 179 clinicians
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

1006 Ford Ave
Owensboro, KY 42301-4677
Phone (270) 688-4845

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01049522AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary's Medical Group, LLC Family Medicine CurrentSince Dec 10, 2014 Accepting new patients
St Mary's Medical Group, LLC CurrentSince Dec 10, 2014 Accepting new patients
Deaconess Cross Pointe Past Accepting new patients
St. Mary's Health, Inc Family Medicine Past Accepting new patients
Deaconess Cross Pointe Center, LLC Past Accepting new patients

Locations

1116 Millis Ave
Ste 101
Boonville, IN 47601
Phone (812) 897-7175

1332 Lincoln Ave
Evansville, IN 47714
Phone (812) 476-4362

711 Saint Marys Dr
Evansville, IN 47714
Phone (812) 479-4437

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

Networks

  • IL PPO Downstate
  • KY PPO
  • IL HMO C-SNP
  • KY PPO C-SNP
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • OH PPO

Interoperability endpoints

  • Direct secure messaging: eric.brackett.3@7598.direct.athenahealth.com
  • Direct secure messaging: eric.brackett.4@7598.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1003993288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SAINT MARYS DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SAINT MARYS DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140508",
            "telephone_number": "812-485-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01049522A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eric.brackett.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "711 Saint Marys Dr",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.