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BRADLEY P GRANT MD PA
NPI 1083894125
Specialist in W Melbourne, FL

Active since November 06, 2007CLIA 10D1042584 · Certificate of Compliance
1480 S WICKHAM RD, W MELBOURNE, FL 32904(321) 724-2188(321) 724-2833 Get Directions Write a Review

NPPES record last updated: June 26, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Bradley P Grant Md Pa NPPES

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

BRADLEY P GRANT MD PA (NPI 1083894125) is a healthcare organization registered as a specialist in W Melbourne, Florida and active in the NPI registry since November 2007. The organization holds a CLIA Certificate of Compliance certificate valid through August 15, 2027 and lists Bradley P Grant, Owner, as its authorized official.

NPPES Registry Identity

NPI1083894125
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBRADLEY P GRANT MD PA
Location Address1480 S WICKHAM RDW Melbourne, FL 32904-2447
Mailing Address1480 S Wickham RdW Melbourne, FL 32904-2447 · (321) 724-2188 · Fax (321) 724-2833
Phone(321) 724-2188
Fax(321) 724-2833
Organization SubpartNo
Authorized OfficialBradley P GrantOwner · (321) 724-2188
Enumeration DateNovember 6, 2007
Last NPPES UpdateJune 26, 2008
✔ NPI 1083894125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1480 S WICKHAM RD, W Melbourne, FL 32904
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Other Identifiers 1

Medicare PINK8132FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley P Grant Md Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Bradley P Grant MD PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Bradley Grant, M.D.
Dermatology
NPI 1528066073
1480 S WICKHAM RD
West Melbourne, FL 32904
(321) 724-2188
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D1042584

Bradley P Grant MD PA · West Melbourne, FL
Active · expires Aug 15, 2027
CLIA Number10D1042584
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2025
Certificate Expiration DateAugust 15, 2027
Laboratory DirectorBradley P. Grant
Laboratory Phone(321) 724-2188
Laboratory LocationBradley P Grant MD PA1480 S Wickham Rd, West Melbourne, FL 32904
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley P Grant MD PA's NPI number?

The NPI number for Bradley P Grant MD PA is 1083894125. It was assigned to this organization in the NPPES registry on November 6, 2007.

Where is Bradley P Grant MD PA located?

Bradley P Grant MD PA is located at 1480 S Wickham Rd, W Melbourne, FL 32904. The listed phone number is (321) 724-2188.

What is Bradley P Grant MD PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Bradley P Grant MD PA enrolled in Medicare?

Yes. Bradley P Grant MD PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bradley P Grant MD PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Bradley P Grant MD PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bradley P Grant MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D1042584) is associated with this NPI, valid through August 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bradley P Grant MD PA was last updated on June 26, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.