Grant Bracken, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0006486 Issued in CO

Practice address

340 Exempla Cir Ste 300
Lafayette, CO 80026-3384

Phone

(303) 673-1390

Fax

(720) 627-6407

NPI assigned

Apr 23, 2020

Sex

Male

Sole proprietor

Yes

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 CO

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

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intermountain Medical Group Denver LLCGroup PAC ID 0840513552, 571 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Medical Center LLC Hospital, Lafayette, CO, CCN 060116

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gbracken247940@direct.intermountainhealth.org

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.

• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1083021083
  Medicare reassignment Care Compare group NPD (past)
• Intermountain Medical Group Denver, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Denver, CO
  • NPI 1083598874
  NPD
• Intermountain Medical Group Denver, LLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1467164723
  NPD

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

• Good Samaritan Medical Center, LLC

  • General Acute Care Hospital
  • Lafayette, CO
  • NPI 1407845035
  Care Compare affiliation

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1164042727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EXEMPLA CIR STE 300",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263384",
            "telephone_number": "303-673-1390",
            "fax_number": "720-627-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EXEMPLA CIR STE 300",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263384",
            "telephone_number": "303-673-1390",
            "fax_number": "720-627-6407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "GRANT",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0006486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Brienne Bowman
• Emma Bowman
• Gretchen Ann Bowman, RN
• Susanne Rachel Boykin, CCC-SLP
• Eric Cornwell Boysen, M.D.
• Paulette Bradford
• Laura Bradshaw, RN
• Thomas H Brady
• Mary Elisabeth Bramel, AUD, CCC-A
• Paul Kenneth Branch, M.D.

• Physician Assistant in Lafayette, CO
• Providers in Lafayette, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.