NPIMap

Individual provider Active NPI

Matthew Bracken, PA-C

  • Physician Assistant
  • Hagerstown, MD
National Provider Identifier
1275998122
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0008589 Issued in MD
Practice address
13 Western Maryland Pkwy Ste 104
Hagerstown, MD 21740-6474
Phone
(301) 665-4575
Fax
(301) 665-4576
NPI assigned
Dec 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0008589 MD Primary

Addresses

Primary practice location

13 Western Maryland Pkwy Ste 104
Hagerstown, MD 21740-6474

Mailing address

13 Western Maryland Pkwy Ste 104
Hagerstown, MD 21740-6474
Phone (301) 665-4575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20221130000777 MD Practitioner - Physician Assistant 8022486752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meritus Medical Center IncGroup PAC ID 7113811795, shared by 8 NPIs, 730 clinicians

Practice addresses (Care Compare)

11110 Medical Campus Rd
Hagerstown, MD 21742-6700

13 Western Maryland Pkwy
Hagerstown, MD 21740-6474

86 Thomas Johnson CT
Frederick, MD 21702-4348
Phone (301) 694-8311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0008589MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 14, 2022 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 14, 2022 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

13 Western Maryland Pkwy
Ste 104
Hagerstown, MD 21740
Phone (301) 665-4575

Interoperability endpoints

  • Direct secure messaging: 04mbracken@cfaortho.emadirect.md

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1450483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1275998122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 WESTERN MARYLAND PKWY STE 104",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406474",
            "telephone_number": "301-665-4575",
            "fax_number": "301-665-4576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 WESTERN MARYLAND PKWY STE 104",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406474",
            "telephone_number": "301-665-4575",
            "fax_number": "301-665-4576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-19",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0008589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.