Active NPI
Alexander Alfonso Craddock, PA-C
- Physician Assistant
- Boca Raton, FL
National Provider Identifier
1922972223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9120741
- Practice address
- 23143 L Ermitage Cir
Boca Raton, FL 33433-7154 - Phone
- (561) 212-2572
- NPI assigned
- Oct 1, 2025
- Last updated
- Oct 1, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9120741 | FL | Primary |
Addresses
Primary practice location
23143 L Ermitage Cir
Boca Raton, FL 33433-7154
Mailing address
23143 L Ermitage Cir
Boca Raton, FL 33433-7154
Phone (561) 212-2572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9120741 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1922972223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23143 L ERMITAGE CIR",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334337154",
"telephone_number": "561-212-2572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23143 L ERMITAGE CIR",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334337154",
"telephone_number": "561-212-2572"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRADDOCK",
"first_name": "ALEXANDER",
"middle_name": "ALFONSO",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-10-01",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9120741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; 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.