Brandon Braddock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108661 Issued in FL

Practice address

300 Health Park Blvd
Suite 4000
Saint Augustine, FL 32086-3707

Phone

(904) 824-8666

NPI assigned

Apr 23, 2015

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2026 through Jan 1, 2028

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: bbraddock742897@direct.shands.ufl.edu

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

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1336536697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PEGGY PL",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867199",
            "telephone_number": "904-540-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "SUITE 4000",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320863707",
            "telephone_number": "904-824-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3175 A1A South, Suite 2",
            "address_purpose": "LOCATION",
            "city": "St. Augustine",
            "state": "FL",
            "postal_code": "32080",
            "country_code": "US",
            "telephone_number": "904-540-5454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADDOCK",
        "first_name": "BRANDON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-23",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Ann Boydston
• Roxeanna R Boyette
• Brittany Bozeman
• Dori C. Bozung, A.P.
• BP Builders Inc
• Thomas Martin Bradley, HIS
• Dareon Bradwell
• Kaylan Brady, M.D.
• Michael Keith Brady, PHARM.D.
• Traci L Bragg, M.D.

• Physician Assistant in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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; Opt Out Affidavits.
• 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.