Individual provider Active NPI

Bradley A Martino, DO

  • Family Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1194216218
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101025671 Issued in MI
Practice address
1091 S Beacon Blvd
Grand Haven, MI 49417-2607
Phone
(616) 604-0096
Fax
(616) 604-0095
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.017385 OH
Family Medicine Physician 207Q00000X 5101025671 MI Primary

Addresses

Primary practice location

1091 S Beacon Blvd
Grand Haven, MI 49417-2607

Mailing address

4400 E 8 Mile Rd
Detroit, MI 48234-1003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH, NE3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220201001666 MI Practitioner - Family Practice 6002209707 Reassigns benefits to 2 organizations
I20240909001479 OH Practitioner - Emergency Medicine 6002209707 Reassigns benefits to 1 organization
I20250909001527 NE Practitioner - Osteopathic Manipulative Medicine 6002209707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Box Butte General HospitalGroup PAC ID 9638089584, shared by 7 NPIs, 60 clinicians

Practice addresses (Care Compare)

2091 Box Butte Ave
Suite 700
Alliance, NE 69301-4458
Phone (308) 762-7244

2101 Box Butte Ave
Alliance, NE 69301-4444

2101 Box Butte Ave
Alliance, NE 69301-4445
Phone (308) 762-6660

PO Box
Suite 678
Alliance, NE 69301

Hospital & facility affiliations

  • Box Butte General Hospital Hospital, Alliance, NE, CCN 281360

Merit-based Incentive Payment System (MIPS)

Final score
84.04 of 100Reported as group
Quality
60.55
Promoting interoperability
100
Improvement activities
40
Cost
78.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc., CurrentSince Jul 17, 2024 Accepting new patients
Synanon Inc CurrentSince Feb 7, 2024 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jul 17, 2024 Accepting new patients
Hackley Community Care Center, Inc CurrentSince Jan 1, 2022 Accepting new patients
Hackley Community Care Center Inc Family Medicine Current Accepting new patients
Hackley Community Care Center Inc Current Accepting new patients
Hackley Community Care Center, Inc CurrentSince Jan 1, 2022 Accepting new patients
Kings Daughters Medical Specialties Inc Current Accepting new patients

Locations

1091 S Beacon Blvd
Grand Haven, MI 49417
Phone (616) 604-0096

1675 Leahy St
Ste 315A
Muskegon, MI 49442
Phone (231) 672-7800

1550 Clinton St
Muskegon, MI 49442
Phone (231) 733-6910

2700 Baker St
Fl 3
Muskegon Heights, MI 49444
Phone (231) 733-6607

1901 Argonne Rd
Portsmouth, OH 45662
Phone (740) 991-0911

1242 Crescent Dr
Wheelersburg, OH 45694
Phone (740) 574-8441

Interoperability endpoints

  • Direct secure messaging: bradleymartino@hccc.allscriptsdirect.net

Organizations & group practices 10

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1194216218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 S BEACON BLVD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172607",
            "telephone_number": "616-604-0096",
            "fax_number": "616-604-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINO",
        "first_name": "BRADLEY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.017385",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101025671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.