MOLLY A BRADDOCK (PA-C) – Physician Assistant, NPI 1881134765

MOLLY A BRADDOCK (PA-C) is a healthcare provider. based in Swansea, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 085.006105 (IL). The NPI Number for MOLLY A BRADDOCK (PA-C) is 1881134765

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MOLLY A BRADDOCK (PA-C)
NPI
1881134765
Phone
(618) 628-2588
Address
4948 BENCHMARK CENTRE DR
Enumeration Date
27 February 2017
Last Update Date
3 January 2020

Doctor Profile

Medical School Name
SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
6182440031
Graduation Year
2016 (10 years ago)
PAC ID
1052670502
Group Practice PAC ID
6709138258
Professional Enrollment ID
I20180109001719
Address ID
IL628646784MO4107XPLXX500
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:9State licenses:1Digital endpointsOther names

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for MOLLY A BRADDOCK (PA-C)

  • 4948, Benchmark Centre Drive, Swansea, Saint Clair County, Illinois, 62226, United States

    SWANSEA, IL 622262027

    Phone: (618) 628-2588

    Fax: (618) 628-1363

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 310 Open Payments records for all available years, with a total value of $6,051.

Total Amount is formed as General ($6,051) + Research ($0) + Ownership ($0) = $6,051.

Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($936).

Total Amount

$6,051

General + Research + Ownership

Payments

310

Total payment records

General Amount

$6,051

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180109001719IPhysician AssistantILTBD
I20250321002107IPhysician AssistantMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths715145$0
99213Established patient office or other outpatient visit, 20-29 minutes227189$0
17000Destruction of precancer skin growth, 1 growth218188$0
17110Destruction of skin growth, 1-14 growths133119$0
99212Established patient office or other outpatient visit, 10-19 minutes9084$0
View full utilization report →

Insurance plans in this area (ZIP 62226)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709138258View full group profile
NameSpecialtyState
Nurse PractitionerMN
Nurse PractitionerKY
D E R M A T O L O G YMN
Nurse PractitionerIL
Pathology, DermatologyMO
Micrographic Dermatologic Surgery (Mds)NY
D E R M A T O L O G YIL
Physician AssistantIL

Reviews

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Frequently asked questions

What is the 10-digit NPI for MOLLY A BRADDOCK (PA-C)?
MOLLY A BRADDOCK (PA-C) — NPI 1881134765 — is the standard way to identify this listing.
Does CMS list MOLLY A BRADDOCK (PA-C) as active?
Yes — MOLLY A BRADDOCK (PA-C) is active in the NPI listing used on this page.
What is MOLLY A BRADDOCK (PA-C)'s specialty?
The listing groups MOLLY A BRADDOCK (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect MOLLY A BRADDOCK (PA-C) on a map?
Expect Swansea, Illinois as a primary anchor for MOLLY A BRADDOCK (PA-C) unless the record lists multiple sites.
Is the information about MOLLY A BRADDOCK (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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