NPIMap

Individual provider Active NPI

Joe McKinley Braden, PA-C

  • Physician Assistant
  • Apollo Beach, FL
National Provider Identifier
1619960804
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101501 Issued in FL
Practice address
282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone
(813) 645-4068
Fax
(813) 645-0312
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9101501 FL Primary

Addresses

Primary practice location

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261

Mailing address

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone (813) 645-4068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000838 FL Practitioner - Physician Assistant 5193799054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brandon Area Primary Care PAGroup PAC ID 1759288269, 12 clinicians

Practice addresses (Care Compare)

282 Apollo Beach Blvd
Apollo Beach, FL 33572-2261
Phone (813) 645-4068

500 Vonderburg Dr
Brandon, FL 33511-5978
Phone (813) 654-2445

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bach & Godofsky M D P a Past Accepting new patients
Vascular and Surgery Assoc Past Accepting new patients
Pointe West Infectious Diseases P L Past Accepting new patients
Tennessee Em-I Medical Services, PC Past Accepting new patients

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1619960804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722261",
            "telephone_number": "813-645-4068",
            "fax_number": "813-645-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 APOLLO BEACH BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722261",
            "telephone_number": "813-645-4068",
            "fax_number": "813-645-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADEN",
        "first_name": "JOE",
        "middle_name": "MCKINLEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apollo Beach, FL

Sources for this page

Verify at the official NPI Registry.