Brandon Ceccacci

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61124689 Issued in WA

Practice address

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Phone

(206) 616-4001

Fax

(206) 616-3889

NPI assigned

Sep 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• CS Pacs 3 Northwest, LLC

  • Hospitalist Physician
  • Puyallup, WA
  • NPI 1811752066
  Medicare reassignment
• Wa Pacs 2 PC

  • Hospitalist Physician
  • Tacoma, WA
  • NPI 1144706532
  Medicare reassignment
• Washington Pac Services PC

  • Hospitalist Physician
  • Spokane, WA
  • NPI 1336678168
  Medicare reassignment

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682812800000",
    "number": "1053960393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECCACCI",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2023-04-30",
        "certification_date": "2023-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61124689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selene M Cazares Espinosa
• CBT Clinical Management LLC
• Jennifer Ann Cea, LMT
• Rizza Cea, ARNP, CNM
• Aisling Cearley
• Domonic Stephen Ceccarelli, PTA
• Andrea Cecil
• Ashley Rose Cedar, ARNP
• Brian Cedeno Betancourt Sil
• Debra L Cederbaum, D.D.S.

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.