Dr Kent Thomas Braeutigam, DO is a medicare enrolled "General Practice" physician in Middleburg, Florida. He graduated from medical school in 1985 and has 39 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Physicians Group Services Pa and his current practice location is
3839 County Road 218, Middleburg, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 282-5474.
Dr Kent Thomas Braeutigam is licensed to practice in Florida (license number OS5110) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1063437861.
Physician's Profile
| Full Name | Dr Kent Thomas Braeutigam |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 39 Years |
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| Location | 3839 County Road 218, Middleburg, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kent Thomas Braeutigam graduated from medical school in 1985
NPI Data:
- NPI Number: 1063437861
- Provider Enumeration Date: 07/13/2006
- Last Update Date: 09/15/2022
Medicare PECOS Information:
- PECOS PAC ID: 0345147690
- Enrollment ID: I20100315000113
Medical Identifiers
Medical identifiers for Dr Kent Thomas Braeutigam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063437861 | NPI | - | NPPES |
| 046178400 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | OS5110 (Florida) | Secondary |
| 208D00000X | General Practice | OS5110 (Florida) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Physicians Group Services Pa | 1254238579 | 78 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kent Thomas Braeutigam allows following entities to bill medicare on his behalf.
| Entity Name | Physicians Group Services Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861440810
PECOS PAC ID: 1254238579
Enrollment ID: O20031216000099 |
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| Entity Name | Coastal Health Primary Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1023734340
PECOS PAC ID: 8628447380
Enrollment ID: O20221220001103 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kent Thomas Braeutigam is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kent Thomas Braeutigam, DO
705 Wells Rd Ste 300,
Orange Park, FL 32073-2982
Ph: (904) 282-6331 | Dr Kent Thomas Braeutigam, DO
3839 County Road 218,
Middleburg, FL 32068-5708
Ph: (904) 282-5474 |
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