Individual provider Active NPI

Brittany Lyn Bahle, PA-C

  • Physician Assistant
  • Suttons Bay, MI
National Provider Identifier
1063195006
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1063195006
Practice address
1448 N West Bay Shore Dr
Suttons Bay, MI 49682-9373
Phone
(231) 645-3285
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1063195006 Primary

Addresses

Primary practice location

1448 N West Bay Shore Dr
Suttons Bay, MI 49682-9373

Mailing address

1448 N West Bay Shore Dr
Suttons Bay, MI 49682-9373
Phone (231) 645-3285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1450 Ellis St
Suite 201
Bozeman, MT 59715-8813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1063195006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 N WEST BAY SHORE DR",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829373",
            "telephone_number": "231-645-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1448 N WEST BAY SHORE DR",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829373",
            "telephone_number": "231-645-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHLE",
        "first_name": "BRITTANY",
        "middle_name": "LYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1063195006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suttons Bay, MI

Sources for this page

Verify at the official NPI Registry.