Bradley Ophoff

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

1819 Carew St
Fort Wayne, IN 46805-4705

Phone

(805) 570-2260

NPI assigned

Jul 28, 2020

Last updated

Jul 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Ear Nose Throat and Allergy Specialists PCGroup PAC ID 4183868094, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Michigan Ear, Nose, Throat, and Allergy Specialists, PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Holland, MI
  • NPI 1780029991
  Medicare reassignment Care Compare group
• Metropolitan Hospital

  dba Metro Health Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment
• Metropolitan Hospital

  dba Metro Health - University of Michigan

  • Infusion Therapy Clinic/Center
  • Wyoming, MI
  • NPI 1255807178
  NPD

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

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1275142986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054705",
            "telephone_number": "805-570-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OPHOFF",
        "first_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Oney, COTA
• Godwin Onyeneke, MA
• John T Oo, NP
• Khin Mar Oo, MD
• Open View MRI, LLC
• Ophthalmology Consultants of Fort Wayne
• Ophthalmology Consultants of Fort Wayne PC (Surgery Center of Ophthalmology Consultants)
• Ophthalmology Consultants of Fort Wayne PC
• Ophthalmology Consultants of Fort Wayne, P.C.
• Ophthalmology Consultants of Fort Wayne, P.C.

• Medical Physician Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Medical Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.