Matthew Todd Braddock, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS11091 Issued in FL

Practice address

810 Lane Ave S
Jacksonville, FL 32205-4785

Phone

(904) 783-9680

Fax

(904) 390-7464

NPI assigned

Sep 1, 2009

Last updated

Nov 20, 2024By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brooks Rehabilitation Home Health Home health agency, Jacksonville, FL, CCN 103174
• Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
• Pinnacle Home Care Home health agency, Ormond Beach, FL, CCN 108499
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Ed Fraser Memorial Hospital Hospital, Macclenny, FL, CCN 100134
• Pavilion for Health Care, the Nursing home, Penney Farms, FL, CCN 106096

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbraddock28255@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124
  Medicare reassignment NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD
• Baptist Primary Care Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1790086593

  Family Medicine

  NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• St Vincents Ambulatory Care Inc

  dba Ascension St Vincent's Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Baker County Medical Services Inc

  • Rural Acute Care Hospital
  • Macclenny, FL
  • NPI 1104926401
  Care Compare affiliation
• Baybap, LLC.

  dba Baptist Home Health Care by BAYADA

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1023612884
  Care Compare affiliation
• Brooks Home Care Advantage, Inc.

  dba Brooks Rehabilitation Home Health

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1184895740
  Care Compare affiliation
• Penney Retirement Community, Inc.

  • Skilled Nursing Facility
  • Penney Farms, FL
  • NPI 1285991265

  Nursing home

  Care Compare affiliation
• Pinnacle Home Care of the Villages, Inc.

  dba Pinnacle Home Care

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1134716970
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1251763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1417180886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746638",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746638",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LANE AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054785",
            "telephone_number": "904-783-9680",
            "fax_number": "904-390-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADDOCK",
        "first_name": "MATTHEW",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-01",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS11091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01085486",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01627926",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005982200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linh Truong Bradberry, DMD
• Timothy Bradberry, DMD
• Jenna Taylor Braddock, RD, LDN
• Jessica Ann Braddock
• Kathryn Braddock, ARNP
• Kathryn Braddy-Dillard, APRN-CNP
• Teresa Braddy, R.N.
• Lissi Caryn Bradfield, BCBA
• Scott M. Bradfield, MD
• Bradford Homeliving LLC

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.
• 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.