Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Bradway

Individual provider Surgical Physician Assistant · NPI 1639698236

Nicole Bradway is a Physician Assistant in Royal Oak, Michigan. Graduated from Mercy College in 2017, 9 years ago. Practices with White Plains Physician Services PC, a 384-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Trained at
Mercy College
Licensed in
MI
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

30575 Woodward Ave
Royal Oak, MI 48073-0980
Phone: (248) 280-8550
Fax: (844) 266-0093
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 3901 Beaubien St Ste 1, Detroit, MI 48201-2119 — (313) 745-5227
  • 45816 Schoenherr Rd, Shelby Twp, MI 48315-6028 — (586) 842-2400

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601010351 (MI)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1639698236
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 14, 2017
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026
Mailing addressPo Box 18998, Belfast, ME 04915-4084

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMERCY COLLEGE
Graduated 2017 (9 years in practice)
Group practice White Plains Physician Services Pc — 384 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Royal Oak