Benjamin Earl Brackett, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05586 Issued in TX

Practice address

333 1St St Ste a
San Francisco, CA 94105-2661

Phone

(415) 840-0560

NPI assigned

Feb 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TX, CA, IL, PA4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Circle Medical Care of California

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1134596091

  CA

  Medicare reassignment Care Compare group
• Circle Medical Care Group PA

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1972358760

  IL, PA, TX

  Medicare reassignment
• Circle Medical Care Group PA

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1366297699
  NPD (past)
• Parker Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Weatherford, TX
  • NPI 1689923740

  Physician Assistant

  NPD (past)
• Primecare Emergency Center - Arlington LLC

  • General Acute Care Hospital
  • Arlington, TX
  • NPI 1376993857
  NPD (past)
• Trans Aero Limited

  • Air Ambulance
  • Artesia, NM
  • NPI 1083155386
  NPD (past)

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Circle Medical Care of California 71 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1881872018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 1ST ST STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941052661",
            "telephone_number": "415-840-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 1ST ST STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941052661",
            "telephone_number": "415-840-0560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 S La Salle St Ste 814",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606041101",
            "country_code": "US",
            "telephone_number": "415-840-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "BENJAMIN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2018-0030",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9112434",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7893",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61278699",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05586",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.007821",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063553",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58410",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "36677",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195992604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1959926-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195992602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195992603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andries E. Braat, MD
• Katharina Maria Brab, MD, PHD
• Enoch C. Brabant, MD
• Maria Helen Bracamonte, LCSW
• Anna Noel Bracewell, M.D.
• Reid Fisher Brackin, M.D
• Courtney Bracy
• Lewis F Bracy, M.A.
• Nathan Tarrell Bracy Sr.
• Kristin M Bradach, PH.D.

• All providers in San Francisco, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.