CMS-1500 Box 24J / 33a • NPI
1396855813
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363A00000X (CMS 97)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant
Box 32 Service Location & ZIP+4
3055 COUNTY ROAD 210 W STE 110, ST JOHNS, FL, 32259-7001
✓ 9-Digit EDI 837 ZIP+4 (32259-7001)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1396855813 (JUANITA DENAE BRACY, PA-C, MPA, ATC, MEd.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1396855813)
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Albuterol Sulfate Hfa Albuterol Sulfate | 11 | <11 |
| Amlodipine Besylate Amlodipine Besylate | 11 | <11 |
| Atorvastatin Calcium Atorvastatin Calcium | 14 | 11 |
| Gabapentin Gabapentin | 12 | <11 |
| Omeprazole Omeprazole | 11 | <11 |
| Rosuvastatin Calcium Rosuvastatin Calcium | 14 | 11 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1396855813 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | JUANITA DENAE BRACY, PA-C, MPA, ATC, MEd. |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant NUCC Code: 363A00000X (Physician Assistant) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 3055 COUNTY ROAD 210 W STE 110, ST JOHNS, FL, 32259-7001 |
| Practice Telephone / Fax | Tel: (214) 580-7277 |
| Administrative Mailing Address | 6800 SOUTHPOINT PKWY STE 300, JACKSONVILLE, FL, 32216-8203 |
| Enumeration & Last Sync | Enumerated: 2006-08-30 | CMS Record Updated: 2025-07-28 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
🗺️ Open in Google Maps 🏥 More Providers in ST JOHNS
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Plain-English Taxonomy & CMS Crosswalk (363A00000X)
What Does Taxonomy Code 363A00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363A00000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (JUANITA DENAE BRACY, PA-C, MPA, ATC, MEd.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
2255A2300X — Specialist/Technologist, Athletic TrainerPlain English: Licensed & Credentialed Specialist/Technologist, Athletic Trainer | State: VA | License: 012000864 | Primary: Secondary |
2255A2300X — Specialist/Technologist, Athletic TrainerPlain English: Licensed & Credentialed Specialist/Technologist, Athletic Trainer | State: CA | License: Verified | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: NC | License: 306479 | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: CA | License: PA60497 | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: N/A | License: Verified | Primary: Secondary |
363AM0700X — Physician Assistant, MedicalPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant, Medical | State: TX | License: PA15256 | Primary: Secondary |
363A00000X — Physician AssistantPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Physician Assistant | State: FL | License: PA9118228 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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