DR. DOMENICK BRACCIA DO - NPI 1821178005 - Family Medicine in Fort Washington, PA

Q: What is Domenick Braccia's NPI number?

The NPI number for Domenick Braccia is 1821178005. It was assigned to this individual provider in the NPPES registry on October 16, 2006.

Q: What is Domenick Braccia's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Addiction Medicine, with taxonomy code 207QA0401X.

Q: Is Domenick Braccia enrolled in Medicare?

No. Domenick Braccia has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Domenick Braccia was last updated on March 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Domenick Braccia Do NPPES

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

DR. DOMENICK BRACCIA DO (NPI 1821178005) is an individual addiction medicine provider in Fort Washington, Pennsylvania, licensed in Pennsylvania (0S006737L) and active in the NPI registry since October 2006. He has opted out of Medicare through July 1, 2027 and maintains a secondary practice location in Harleysville.

NPPES Registry Identity

NPI1821178005

Entity TypeIndividualMale

Primary Taxonomy207QA0401X

Provider Legal NameDR. DOMENICK BRACCIACredential: DO

Location Address1035 VIRGINIA DRFort Washington, PA 19034-3103

Mailing Address1035 Virginia DrFort Washington, PA 19034 · (267) 419-7710

Phone(267) 419-7710

Sole ProprietorNo

Enumeration DateOctober 16, 2006

Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration

✔ NPI 1821178005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Addiction MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QA0401X

License✔ Licensed in PA · 0S006737L

Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 0S006737L (PA)

1035 VIRGINIA DR, Fort Washington, PA 19034

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Secondary Practice Location 1

Location 1345 Main St, Suite 4Harleysville, PA 19438-2428 · Phone (215) 256-0050 · Fax (215) 256-0059

Other Identifiers 1

Medicaid0012371310008PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Domenick Braccia Do has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2015 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2015

Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

MADDIE WENDLER

Counselor (Addiction (Substance Use Disorder))