| Dr Matthew Todd Braddock, DO | |
|
810 Lane Ave S, Jacksonville, FL 32205-4785 | |
| (904) 783-9680 | |
| (904) 390-7464 |
| Full Name | Dr Matthew Todd Braddock |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 16 Years |
| Location | 810 Lane Ave S, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417180886 | NPI | - | NPPES |
| P01085486 | Other | FL | RAILROAD MEDICARE |
| P01627926 | Other | FL | RR MEDICARE |
| 005982200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS11091 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Home Health Care | Jacksonville, FL | Home health agency |
| Baptist Health Medical Center - Jacksonville | Jacksonville, FL | Hospital |
| Ascension St Vincent's Riverside | Jacksonville, FL | Hospital |
| Ed Fraser Memorial Hospital | Macclenny, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Baptist Primary Care Inc | 0648177733 | 420 |
| Entity Name | Baptist Primary Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508817529 PECOS PAC ID: 0648177733 Enrollment ID: O20031217000248 |
| Entity Name | Inpatient Consultants Of Florida, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396795597 PECOS PAC ID: 4789614785 Enrollment ID: O20050819000018 |
| Entity Name | St Vincent's Ambulatory Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417987124 PECOS PAC ID: 2860411188 Enrollment ID: O20051116000430 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Matthew Todd Braddock, DO Po Box 746638, Atlanta, GA 30374-6638 Ph: (904) 202-2092 | Dr Matthew Todd Braddock, DO 810 Lane Ave S, Jacksonville, FL 32205-4785 Ph: (904) 783-9680 |
Dr. Wissam M Shaya, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4235 Sunbeam Rd, Jacksonville, FL 32257 Phone: 904-322-8555 Fax: 904-322-8578 | |
Kristie Driver, M.D.,M.P.H Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5011 Gate Pkwy Bldg 100, Jacksonville, FL 32256 Phone: 904-523-3351 Fax: 904-523-3340 | |
Dr. Neal Raj Verma, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 2624 Atlantic Blvd, Jacksonville, FL 32207 Phone: 954-513-3240 Fax: 904-398-7871 | |
Timothy Davlantes, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 | |
Dr. Marcia Wayne Funderburk, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1255 Lila St, Ufjp Lem Turner Family Practice Center, Jacksonville, FL 32208 Phone: 904-244-5802 Fax: 904-244-5791 | |
Dr. Terry Dale Hashey, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9130 Rg Skinner Parkway, Jacksonville, FL 32256 Phone: 904-538-0950 Fax: 904-538-0952 | |
Dr. Christopher Patrick Carroll, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 820 Prudential Dr Ste 304, Jacksonville, FL 32207 Phone: 904-202-3860 Fax: 904-202-3846 |