Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Bradley Scott Boutcher, PA-C

Individual provider Physician Assistant · NPI 1730840729

Mr. Bradley Scott Boutcher, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2021, 5 years ago. Practices with Cardiothoracic and Vascular Surgical Associates PA, a 85-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

836 Prudential Dr Ste 1804
Jacksonville, FL 32207-8345
Phone: (904) 398-3888
Fax: (904) 400-6675
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9115278 (FL)

Record details

NPI number1730840729
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 3, 2022
Last updated in NPPESMarch 31, 2025
Certification dateMarch 31, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Cardiothoracic And Vascular Surgical Associates Pa — 85 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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