Jacqueline Bracy, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C043356 Issued in CA

Practice address

210 S Grand Ave
Suite 324
Glendora, CA 91741-4205

Phone

(626) 852-0411

Fax

(626) 852-0407

NPI assigned

Dec 13, 2006

Last updated

Aug 30, 2016By the provider in NPPES

Sex

Female

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jacqueline Bracy, M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Glendora, CA
  • NPI 1043590912
  Authorized official Same address or phone
• Citrus Valley Physician Partners

  • Specialist
  • West Covina, CA
  • NPI 1043703150
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1396806253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1418",
            "address_2": "SUITE 324",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917401418",
            "telephone_number": "626-852-0411",
            "fax_number": "626-852-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S GRAND AVE",
            "address_2": "SUITE 324",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414205",
            "telephone_number": "626-852-0411",
            "fax_number": "626-852-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACY",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C043356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Bou Sleiman, RDN
• Guadalupe Garcia Boudreaux, APCC
• Najib Bouz, M.D.
• Stephen Warren Bowen, D.M.D.
• Lori Boyer
• Bradford Residential Care Inc.
• Kirsten Ashley-Marie Brandenburg, LMFT
• Brandon Au DDS Inc (New Vision Dental)
• Sarah Breitschwerdt
• Michelle Ariane Brereton, PA

• Obstetrics & Gynecology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.