Bradley James Centala
Individual provider Active NPI Physician Assistant · Allen Park, MI
NPI 1194477075 · NPPES record last updated Apr 2, 2025
Key facts
- NPI
- 1194477075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601011149 (MI)
- Practice address
- 7226 Allen Rd
Allen Park, MI 48101-2060 - Phone
- (313) 874-4806
- NPI assigned
- Jan 22, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Henry Ford Wyandotte Hospital
Practice addresses (Care Compare)
2070 Biddle Ave
Suite 2
Wyandotte, MI 48192-4080
Phone (734) 284-7482
7226 Allen Rd
Allen Park, MI 48101-2060
Phone (734) 383-5530
Hospital & facility affiliations
- Wyandotte Hospital and Medical Center
- Henry Ford Health Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220727000557 | MI | Practitioner - Physician Assistant | 2163804915 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601011149 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Wyandotte Hospital | Current |
Accepting new patients | |
| Henry Ford Wyandotte Hospital | Current |
Accepting new patients | |
| Physician Coverage Services | Past | Accepting new patients | |
| Henry Ford Wyandotte Hospital | Past | Accepting new patients |
Locations
7226 Allen Rd
Allen Park, MI 48101
Phone (313) 383-5530
2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482
Interoperability endpoints
- bcentala1088022@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601011149 | MI | Yes |
Addresses
Primary practice location
7226 Allen Rd
Allen Park, MI 48101-2060
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (138) 744-8063
Other practice location 1
1528 Huntington Blvd
Grosse Pointe Woods, MI 48236-2533
Phone (313) 910-5152
Other providers in Allen Park, MI
- Caremed Pharmacy LLC
- Caress Home Health Care Services LLC
- Marcia Jean Carr
- Anna Marisa Castillo
- Ann M Caulfield-Cook
- Mansuk Chae
- Venkata Chalam
- Champaign Pharmacy LLC
- Kimberly Joy Chandler
- Kristen Chapman
All providers in Allen Park, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.