NICOLE BRADWAY
NPI 1639698236
Physician Assistant in Royal Oak, MI

Q: What is Nicole Bradway's NPI number?

The NPI number for Nicole Bradway is 1639698236. It was assigned to this individual provider in the NPPES registry on September 14, 2017. The provider is also known as Nicole Shelly Pa-C.

Q: What is Nicole Bradway's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Bradway was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.

Active since September 14, 2017PECOS EnrolledAccepts Medicare Assignment

99.15/100

CMS Quality Rating

30575 WOODWARD AVE, ROYAL OAK, MI 48073(248) 280-8550(844) 266-0093 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 19, 2026, May 11, 2026, Apr 27, 2026 and 3 more (6 updates tracked since 2017).

On this page

About Nicole Bradway NPPES

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

NICOLE BRADWAY (NPI 1639698236) is an individual physician assistant in Royal Oak, Michigan, licensed in Michigan (5601010351) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, is affiliated with White Plains Hospital Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1639698236

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameNICOLE BRADWAY

Location Address30575 WOODWARD AVERoyal Oak, MI 48073-0980

Mailing AddressPo Box 18998Belfast, ME 04915-4084 · (469) 803-3000

Phone(248) 280-8550

Fax(844) 266-0093

Sole ProprietorYes

Medical School CMSMercy CollegeGraduated 2017

Enumeration DateSeptember 14, 2017

Last NPPES UpdateMay 19, 20266 updates tracked since enumeration

NPPES CertifiedMay 19, 2026

✔ NPI 1639698236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MI · 5601010351

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X

30575 WOODWARD AVE, Royal Oak, MI 48073

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Other Names 1

Former Name (1)Nicole Shelly Pa-c

Secondary Practice Locations 2

Location 13901 Beaubien St Ste 1Detroit, MI 48201-2119 · Phone (313) 745-5227 · Fax (313) 745-5596

Location 245816 Schoenherr RdShelby Twp, MI 48315-6028 · Phone (586) 842-2400 · Fax (833) 561-1976

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Bradway is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3476819517

PECOS Enrollment IDI20171107000468, I20260513000433

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

22 services21 patients

Relocation of one muscle of shoulder or upper arm 23395

Relocation of a shoulder or upper arm muscle is a procedure aimed at repositioning a displaced muscle. This helps improve mobility and reduce discomfort. It's performed under anesthesia and involves making an incision, moving the muscle, and then closing the wound.

21 services20 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

19 services18 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

16 services15 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

15 services12 patients

Removal of extensive shoulder joint tissue using an endoscope 29823

This procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.

11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

White Plains Hospital Center

Acute Care Hospitals · White Plains, NY

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330304

Location41 East Post R0adWhite Plains, NY 10601 · Westchester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

99.15/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID M MONTGOMERY M.D.

Orthopaedic Surgery