Thomas Hien Bracker, PA-C

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

PA217593 Issued in OR

Practice address

2801 N Gantenbein Ave
Portland, OR 97227-1623

Phone

(503) 276-6500

NPI assigned

Sep 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Practice roles

Locations

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.

• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Portland, OR
  • NPI 1215983200
  Medicare reassignment
• Northwest Acute Care Specialists PC

  • Emergency Medicine Physician
  • Vancouver, WA
  • NPI 1487811048
  NPD

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1942978853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SW MAIN ST STE 940",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043216",
            "telephone_number": "503-464-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-276-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKER",
        "first_name": "THOMAS",
        "middle_name": "HIEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-03",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "OR",
            "license": "PA217593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Brabham, NCC
• Travis Brace, PHD
• Brian Bracelin, LCSW
• Amanda Jaclyn Brachfeld, BCBA
• Raymond Benjamin Bracis, M.D.
• David Richard Brackett
• Brad R Hagedorn DMD PC
• Daniel Bradach
• Andrew Bradbury
• Robert Rich Bradbury Jr., MSW

• Pediatric Emergency Medicine (Pediatrics) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.