Jacqueline Claire Bragunier, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0003956 Issued in MD

Practice address

3500 Old Washington Rd
101
Waldorf, MD 20602

Phone

(301) 645-1133

Fax

(301) 645-2369

NPI assigned

Feb 14, 2007

Sex

Female

Sole proprietor

No

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  NPD
• Cambridge Pediatrics, LLC

  • Pediatrics Physician
  • Waldorf, MD
  • NPI 1154462943
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Nova Physician Wellness Center PLLC

  • Family Medicine Physician
  • Fairfax, VA
  • NPI 1215307400
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1467595348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4823 43RD PL NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200164501",
            "telephone_number": "313-729-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 OLD WASHINGTON RD",
            "address_2": "101",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "20602",
            "telephone_number": "301-645-1133",
            "fax_number": "301-645-2369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGUNIER",
        "first_name": "JACQUELINE",
        "middle_name": "CLAIRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0003956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Ann Bosak, RD
• Titiana Regine Boti Bi
• Bowen Psychological Services, LLC
• Archelle Bowen
• Desney Bowen
• Stephanie Branch, OD
• Linda Brantuo
• Brave Resilience Mental Health Services LLC
• Breath of Fresh Air, LLC
• Bridges Healthcare Service, LLC

• Medical Physician Assistant in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.