William Bracker Jr., PSY.D.
Individual provider Active NPI Clinical Psychologist · Wilton Manors, FL
NPI 1407882145 · NPPES record last updated Feb 4, 2023
Key facts
- NPI
- 1407882145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 68 019898 (NY)
- Practice address
- 1881 NE 26TH St Ste 70
Wilton Manors, FL 33305-1425 - Phone
- (954) 895-1022
- NPI assigned
- Jun 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1881 NE 26TH St
Suite 70
Wilton Manors, FL 33305-1425
Phone (954) 895-1022
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090626000413 | FL | Practitioner - Clinical Psychologist | 4688725906 | Reassigns benefits to 2 organizations |
| I20150714001069 | NY | Practitioner - Psychologist Billing Independently | 4688725906 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68 019898 | NY | MD | Clinical Psychologist |
| 019898 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doctor on Demand Professionals P C | Current |
Accepting new patients | |
| Bill Bracker, PSYD, LLC | Clinical | Current |
Accepting new patients |
| Gay Men'S Health Crisis, Inc. | Current |
Accepting new patients |
Locations
1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926
915 Middle River Dr
Ste 307
Ft Lauderdale, FL 33304
Phone (954) 566-2166
1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233
1881 NE 26th St
Ste 70
Wilton Manors, FL 33305
Phone (954) 317-3978
446 W 33rd St
#6
New York, NY 10001
307 W 38th St
Frnt 8
New York, NY 10018
Phone (212) 367-1225
446 W 33rd St
New York, NY 10001
Phone (212) 367-1284
Interoperability endpoints
- bill.bracker.1@30520.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY6093 | FL | |
| Clinical Psychologist | 103TC0700X | 68 019898 | NY | Yes |
Addresses
Primary practice location
1881 NE 26TH St Ste 70
Wilton Manors, FL 33305-1425
Mailing address
PO Box 4722
Fort Lauderdale, FL 33338-4722
Phone (954) 895-1022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54526 | Other | FL | BCBS |
Other providers in Wilton Manors, FL
- Bioscrip Pharmacy, Inc.
- Trista Birdwell
- Kevin Robert Bochenek
- Maria L Bondi
- Fred F Boykin
- Brad Zucker Consulting
- Tasia Arianna Bradley
- James Brauss
- Giancarlo Brezillion
- William Anthony Brody Jr.
All providers in Wilton Manors, FL · Clinical Psychologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.