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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JACOB ALEXANDER BRADDOCK D.O.
NPI 1801470984
Family Medicine in South Bend, IN

Active since May 06, 2021PECOS EnrolledAccepts Medicare Assignment
714 N MICHIGAN ST, SOUTH BEND, IN 46601(574) 647-7477(574) 647-3655 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 19, 2025, Jul 8, 2024, Jul 1, 2024 and 1 more (4 updates tracked since 2021).

About Dr. Jacob Alexander Braddock D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACOB ALEXANDER BRADDOCK D.O. (NPI 1801470984) is an individual family medicine provider in South Bend, Indiana, licensed in Indiana (02007857A) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital Of South Bend, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1801470984
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JACOB ALEXANDER BRADDOCKCredential: D.O.
Location Address714 N MICHIGAN STSouth Bend, IN 46601-1035
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-6592
Phone(574) 647-7477
Fax(574) 647-3655
Sole ProprietorNo
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2021
Enumeration DateMay 6, 2021
Last NPPES UpdateJune 30, 20264 updates tracked since enumeration
NPPES CertifiedJune 30, 2026
✔ NPI 1801470984 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IN · 02007857A✔ Licensed in KS · 05-51049
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
714 N MICHIGAN ST, South Bend, IN 46601
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1112 W Ross Blvd Ste DDodge City, KS 67801-7220 · Phone (620) 371-7044 · Fax (620) 371-7046
Location 21100 Mercer AveDecatur, IN 46733-2303 · Phone (260) 724-2145 · Fax (260) 728-3867

Other Identifiers 1

Medicaid300091075IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter from Meridian and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jacob Alexander Braddock D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395147722
PECOS Enrollment IDI20240613000540, I20250529000591, I20251108000066
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital Of South Bend

Acute Care Hospitals · South Bend, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150058
Location615 N Michigan StSouth Bend, IN 46601 · St. Joseph County
Emergency services Birthing friendly

Wayne County Hospital

Critical Access Hospitals · Corydon, IA
OwnershipGovernment - Local
CMS Certification Number161358
Location417 South East StreetCorydon, IA 50060 · Wayne County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID HENRY TALARICO MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ABIGAIL LEIGH REESE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
DALE ALAN PATTERSON M.D.
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
MATTHEW T. DUPRE MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
RICHARD J. WARD MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
VICTORIA ANN BAWEL MD
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477
ISAAC D HATTON MD
Family Medicine
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7913
LAURA LAWRENCE DO
Student in an Organized Health Care Education/Training Program
714 N MICHIGAN ST
SOUTH BEND, IN 46601
St. Joseph County (574) 647-7477

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 Jacob Braddock's NPI number?

The NPI number for Jacob Braddock is 1801470984. It was assigned to this individual provider in the NPPES registry on May 6, 2021.

Where is Jacob Braddock located?

Jacob Braddock practices at 714 N Michigan St, South Bend, IN 46601. The listed phone number is (574) 647-7477.

What is Jacob Braddock's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jacob Braddock enrolled in Medicare?

Yes. Jacob Braddock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jacob Braddock accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter from Meridian and 4 other insurers list Jacob Braddock as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jacob Braddock affiliated with any hospitals?

According to CMS data, Jacob Braddock is affiliated with Memorial Hospital Of South Bend and Wayne County Hospital.

When was this NPI record last updated?

The NPPES record for Jacob Braddock was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.