Peter Matthew Bracken, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA14573 Issued in CA

Practice address

23011 Briarhorn Dr
Spring, TX 77389-5244

Phone

(818) 335-3345

NPI assigned

Jun 26, 2006

Last updated

Jul 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Medipro Inc.

  dba Mediplus Multispeciality Medical Grp.

  • Specialist
  • Los Angeles, CA
  • NPI 1376580894
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1780611715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 NEWCASTLE AVE",
            "address_2": "#6",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162012",
            "telephone_number": "818-335-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23011 BRIARHORN DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773895244",
            "telephone_number": "818-335-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "PETER",
        "middle_name": "MATTHEW",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA14573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "PA14573",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A'Nyah De'Shay Boyd
• Antoyia Boyd
• Eleah Marlene Boyd
• Sherri Nicole Boyd, FNP
• Kierra T Boyer- Young
• Kenzie Lynn Bradberry
• Venitra Bradberry
• Amber Nicole Bradford, M.ED
• Jessica Renee Bradley, PT, DPT
• Kimberly L. Bradley, APRN, FNP-BC

• Medical Physician Assistant in Spring, TX
• Providers in Spring, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.