Individual provider Active NPI

Scott Cameron Braddock, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1326554619
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1149688 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030
Phone
(832) 824-1000
NPI assigned
Dec 21, 2017
Last updated
Jun 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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 1149688 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030

Mailing address

2 Greenway PLZ Ste 300
Houston, TX 77046-0207
Phone (832) 828-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181119003267 TX Practitioner - Physician Assistant 8224382775 Reassigns benefits to 5 organizations
I20260108001265 OK Practitioner - Physician Assistant 8224382775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Baylor College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians
Integrative Emergency Services Physician Group PAGroup PAC ID 0749447936, 71 clinicians
Ies ER Oklahoma LLCGroup PAC ID 5395234678, 135 clinicians

Practice addresses (Care Compare)

12500 S Fwy
Suite 100
Burleson, TX 76028-7128
Phone (214) 294-6250

1500 S Main St
1St FL Outpatient
Ft. Worth, TX 76104-4917
Phone (817) 702-3431

1575 S Main St
JPS Emergency
Fort Worth, TX 76104-4901
Phone (817) 702-8828

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 494-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.56
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5758OKMDPhysical Therapist
1149688TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Oct 1, 2018 Accepting new patients
Baylor College of Medicine CurrentSince Oct 1, 2018 Accepting new patients
St Joseph Emergency Physicians PLLC CurrentSince Feb 1, 2021 Accepting new patients
Ies ER Oklahoma LLC CurrentSince Nov 1, 2025 Accepting new patients
Century Integrated Partners, Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

10501 E 91st St
Tulsa, OK 74133
Phone (918) 307-6000

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

12500 South Fwy
Ste 100
Burleson, TX 76028
Phone (214) 294-6250

3500 Gaston Ave
Dallas, TX 75246

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

2 Greenway Plz
Ste 300
Houston, TX 77046
Phone (832) 828-3603

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

Organizations & group practices 8

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 1

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": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1326554619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460207",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDOCK",
        "first_name": "SCOTT",
        "middle_name": "CAMERON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-21",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1149688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.