Bradley Bliss, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601007455 Issued in MI

Practice address

14477 Caberfae Hwy
Wellston, MI 49689-9315

Phone

(231) 848-4777

NPI assigned

Oct 9, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellston Medical Center PLLCGroup PAC ID 3779533617, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Manistee Hospital Hospital, Manistee, MI, CCN 230303

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellston Medical Center PLLC

  • Rural Health Clinic/Center
  • Wellston, MI
  • NPI 1700973922
  Medicare reassignment Care Compare group
• Kaleva Medical Center

  • Rural Health Clinic/Center
  • Kaleva, MI
  • NPI 1366522146
  NPD Authorized official
• Rural Health Associates LLP

  dba Kaleva Medical Center PLLC

  • Rural Health Clinic/Center
  • Wellston, MI
  • NPI 1255428470
  Authorized official Same address or phone
• Lake County Care Center, Inc.

  dba grand oaks nursing center

  • Skilled Nursing Facility
  • Baldwin, MI
  • NPI 1073509261
  NPD (past)
• Senior Medical Corp. P.C.

  • Geriatric Medicine (Family Medicine) Physician
  • Hesperia, MI
  • NPI 1871677955
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Manistee Hospital

  • General Acute Care Hospital
  • Manistee, MI
  • NPI 1407949191
  Care Compare affiliation

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114014180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14477 CABERFAE HWY",
            "city": "WELLSTON",
            "state": "MI",
            "postal_code": "496899315",
            "telephone_number": "231-848-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14477 CABERFAE HWY",
            "city": "WELLSTON",
            "state": "MI",
            "postal_code": "496899315",
            "telephone_number": "231-848-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "BRADLEY",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601007455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody Ryan Carlson, EMT, I/C
• Amber Ciacelli
• Fischer Corporation
• Jennifer Tabar, LPC, LLC
• Norman Township

• Medical Physician Assistant in Wellston, MI
• Providers in Wellston, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.