Individual provider Active NPI

Bradley James Centala

  • Physician Assistant
  • Allen Park, MI
National Provider Identifier
1194477075
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011149 Issued in MI
Practice address
7226 Allen Rd
Allen Park, MI 48101-2060
Phone
(313) 874-4806
NPI assigned
Jan 22, 2022
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 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 5601011149 MI Primary

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220727000557 MI Practitioner - Physician Assistant 2163804915 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte HospitalGroup PAC ID 2264334499, 194 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601011149MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital CurrentSince Mar 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Mar 1, 2025 Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients
Physician Coverage Services 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

  • Direct secure messaging: bcentala1088022@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1642809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1194477075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "138-744-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7226 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012060",
            "telephone_number": "313-874-4806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1528 Huntington Blvd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe Woods",
            "state": "MI",
            "postal_code": "482362533",
            "country_code": "US",
            "telephone_number": "313-910-5152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CENTALA",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-22",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.