NPIMap

Individual provider Active NPI

Bradley P Goodwin, M.D.

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1326058124
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301072155 Issued in MI
Practice address
4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205
Phone
(231) 935-8930
Fax
(231) 935-8811
NPI assigned
Aug 8, 2006
Last updated
May 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301072155 MI Primary

Addresses

Primary practice location

4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205

Mailing address

4290 Copper Ridge Dr Ste 200
Traverse City, MI 49684-7205
Phone (231) 935-8930

Other identifiers 1

IdentifierTypeStateIssuer
4301072155OtherMILICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040414001480 MI Practitioner - Family Practice 8921998014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Front Primary Care PLLCGroup PAC ID 4183514706, 20 clinicians
Great Lakes Therapy Housecalls PCGroup PAC ID 7719876580, shared by 2 NPIs, 71 clinicians

Practice addresses (Care Compare)

4290 Copper Ridge Dr
Suite 200
Traverse City, MI 49684-7205
Phone (231) 935-8930

9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301072155MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Front Primary Care, P.L.L.C. Family Medicine CurrentSince Aug 6, 2001 Accepting new patients
West Front Primary Care, P.L.L.C. Family Medicine PastSince Aug 6, 2001 Accepting new patients

Locations

3537 W Front St
Ste E
Traverse City, MI 49684
Phone (231) 935-5880

4290 Copper Ridge Dr
Ste 200
Traverse City, MI 49684
Phone (231) 935-8930

Interoperability endpoints

  • Direct secure messaging: bradley.goodwin.p1@direct.wfpc.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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 7

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1326058124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4290 COPPER RIDGE DR STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847205",
            "telephone_number": "231-935-8930",
            "fax_number": "231-935-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4290 COPPER RIDGE DR STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847205",
            "telephone_number": "231-935-8930",
            "fax_number": "231-935-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "BRADLEY",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301072155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301072155",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.