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

Individual provider Physician Assistant · NPI 1265737639

Bradley J Haveman-Gould, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2010, 16 years ago. Practices with Advantage Health/Saint Mary's Medical Group, a 494-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
16
In the registry since
2011
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

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502
Phone: (616) 685-5039
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 200 Jefferson Ave Se, Grand Rapids, MI 49503-4502 — (616) 685-5050

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1265737639
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 17, 2011
Last updated in NPPESJanuary 16, 2024
Certification dateJanuary 16, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Advantage Health/Saint Mary'S Medical Group — 494 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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