Braeden Ryan Spivey

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16543 Issued in TX

Practice address

810 N Zang Blvd
Dallas, TX 75208-4263

Phone

(956) 665-7049

NPI assigned

Jun 26, 2022

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 TX

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

Specialty

Physician Assistant

Education

Univeristy of Texas Rio Grande Valley Med School, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MedhealthGroup PAC ID 9931001567, 435 clinicians

Green Oaks Physical Therapy Limited PartnershipGroup PAC ID 4688582141, shared by 2 NPIs, 208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Dallas Medical Center Hospital, Dallas, TX, CCN 450051

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Medhealth

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  Medicare reassignment Care Compare group NPD (past)
• Medhealth

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD

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

• Methodist Hospitals of Dallas

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1528027786
  Care Compare affiliation

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

{
    "created_epoch": "1656201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1114659513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N ZANG BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084263",
            "telephone_number": "214-941-4243",
            "fax_number": "214-941-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 N ZANG BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084263",
            "telephone_number": "956-665-7049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12230 Coit Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752512323",
            "country_code": "US",
            "telephone_number": "972-566-2663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3450 W Wheatland Rd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752374411",
            "country_code": "US",
            "telephone_number": "214-943-1171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "BRAEDEN",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-26",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Spirrison
• Spisurg LLC
• Sarah Elizabeth Spitz, FNP
• Jack W Spitzberg, MD
• Lauren Spivack, LMFT
• Dara Breanne Spivey, CP, LP
• James Alan Spivey, CRNA
• Jennifer L Spivey, MA, MS, LPC, MT-BC
• Lauren Jannell Spivey, MMFT, MA ED
• Megan Joyce Spivey

• Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.