BRADDOCK MEDICAL GROUP P.A.
NPI 1710980081
Clinic/Center - Primary Care in Cumberland, MD
About Braddock Medical Group P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BRADDOCK MEDICAL GROUP P.A. (NPI 1710980081) is a healthcare organization registered as a primary care in Cumberland, Maryland and active in the NPI registry since May 2005. The organization maintains a secondary practice location in Cumberland and lists Paul Taylor Livengood, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Braddock Medical Group P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Braddock Medical Group P.A., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Braddock Medical Group P.A.'s NPI number?
The NPI number for Braddock Medical Group P.A. is 1710980081. It was assigned to this organization in the NPPES registry on May 31, 2005.
Where is Braddock Medical Group P.A. located?
Braddock Medical Group P.A. is located at 912 Seton Dr, Cumberland, MD 21502. The listed phone number is (301) 722-3111.
What is Braddock Medical Group P.A.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Braddock Medical Group P.A. enrolled in Medicare?
Yes. Braddock Medical Group P.A. is registered in the Medicare PECOS enrollment system.
When is Braddock Medical Group P.A.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Maryland, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Braddock Medical Group P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Braddock Medical Group P.A., in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Braddock Medical Group P.A. was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Braddock Medical Group P.a. · NPI 1710980081
Primary Care organization in Cumberland, Maryland. Organization record, active in the CMS NPPES registry since May 31, 2005.
## Identity
- **NPI:** 1710980081 (Entity type: Organization)
- **Enumerated:** May 31, 2005
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Paul Livengood, OWNER
## Practice location
- **Address:** 912 SETON DR, Cumberland, MD 21502-1818
- **Phone:** (301) 722-3111 · **Fax:** (301) 722-5135
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Maryland, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 21, 2023
- **Other identifiers:** Medicaid 00874296 (PA); Medicaid 910291400 (MD); Other 6216720003; and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1710980081) · Data from the CMS NPPES public registry.