NPIMap

Individual provider Active NPI

Michael John Bradley, DO

  • Family Medicine Physician
  • Pine Grove, PA
National Provider Identifier
1609981992
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS011802 Issued in PA
Practice address
8 Oak Grove Rd Ste 1
Pine Grove, PA 17963-1226
Phone
(570) 345-3321
Fax
(570) 345-6470
NPI assigned
Aug 20, 2006
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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 OS011802 PA Primary

Addresses

Primary practice location

8 Oak Grove Rd Ste 1
Pine Grove, PA 17963-1226

Mailing address

8 Oak Grove Rd Ste 1
Pine Grove, PA 17963-1226
Phone (570) 345-3321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100306000010 PA Practitioner - Family PracticePractitioner - Hospitalist 9133264765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

8 Oak Grove Rd
Suite 1
Pine Grove, PA 17963-1226
Phone (570) 345-3321

Hospital & facility affiliations

Procedures performed for Medicare patients

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Group P C Family Medicine CurrentSince Dec 21, 2020 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Dec 21, 2020 Accepting new patients
Berks Emergency Physicians, LLC Past Accepting new patients

Locations

232 Sunbury St
Minersville, PA 17954
Phone (570) 544-4590

8 Oak Grove Rd
Ste 1
Pine Grove, PA 17963
Phone (570) 345-3321

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

2500 Bernville Rd
Reading, PA 19605
Phone (610) 378-2300

Interoperability endpoints

  • Direct secure messaging: mbradley@imgpc.medentdirect.com

Organizations & group practices 3

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 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1609981992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 OAK GROVE RD STE 1",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631226",
            "telephone_number": "570-345-3321",
            "fax_number": "570-345-6470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 OAK GROVE RD STE 1",
            "city": "PINE GROVE",
            "state": "PA",
            "postal_code": "179631226",
            "telephone_number": "570-345-3321",
            "fax_number": "570-345-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS011802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Grove, PA

Sources for this page

Verify at the official NPI Registry.