Nicole Bradway

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010351 Issued in MI

Practice address

30575 Woodward Ave
Royal Oak, MI 48073-0980

Phone

(248) 280-8550

Fax

(844) 266-0093

NPI assigned

Sep 14, 2017

Last updated

May 19, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Shelly Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY, MI2 enrollments

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 2

Specialty

Physician Assistant

Education

Mercy College, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

White Plains Physician Services PCGroup PAC ID 3476894445, 386 clinicians

Michigan Orthopaedic Surgeons PLLCGroup PAC ID 7810277811, 127 clinicians

Fairway Physical Therapy LLCGroup PAC ID 3971563222, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• White Plains Hospital Center Hospital, White Plains, NY, CCN 330304
• Burke Rehabilitation Hospital Inpatient rehabilitation facility, White Plains, NY, CCN 333030

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.22 of 100Reported as group

Quality

82.55

Promoting interoperability

100

Improvement activities

40

Cost

64.86

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: nicole.bradway.1@9974.direct.athenahealth.com
• Direct secure messaging: nshelly@ons.emadirect.md

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 Orthopaedic Surgeons, PLLC

  • Orthopaedic Surgery Physician
  • Southfield, MI
  • NPI 1306394309
  Medicare reassignment Care Compare group NPD
• White Plains Physician Services PC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1124502687
  Medicare reassignment Care Compare group NPD
• VHS Physicians of Michigan

  dba DMC Medical Group

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment NPD (past)
• Fairway Physical Therapy LLC

  • Physical Therapist
  • Palm Beach Gardens, FL
  • NPI 1376557090
  Care Compare group
• Michigan Orthopaedic Surgeons PLLC

  • Durable Medical Equipment & Medical Supplies
  • Shelby Township, MI
  • NPI 1730838467
  NPD
• Orthopaedic & Neurosurgery Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Greenwich, CT
  • NPI 1033318720

  Physician Assistant

  NPD
• Orthopaedic & Neurosurgery Specialists, PLLC

  • Orthopaedic Surgery Physician
  • Newington, CT
  • NPI 1043086531
  NPD

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

• White Plains Hospital Medical Center

  dba White Plains Hospital Center

  • General Acute Care Hospital
  • White Plains, NY
  • NPI 1447255153
  Care Compare affiliation
• Winifred Masterson Burke Rehabilitation Hospital

  • Rehabilitation Hospital
  • White Plains, NY
  • NPI 1841295219

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1639698236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18998",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "469-803-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30575 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730980",
            "telephone_number": "248-280-8550",
            "fax_number": "844-266-0093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5227",
            "fax_number": "313-745-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45816 Schoenherr Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483156028",
            "country_code": "US",
            "telephone_number": "586-842-2400",
            "fax_number": "833-561-1976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADWAY",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.bradway.1@9974.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "athenaOne",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "30575 Woodward Ave",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480730980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SHELLY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katharine E Brace, LMSW
• Olivia Jane Brack
• Olivia Bradin
• Anthony Bradley
• Mikaela Bradley, CGC
• Pavan Brahmamdam, MD
• Alyssa Brandenburg, OTR/L
• Shawn Brandenburg, M.D.
• Nathan James Branson, PA-C
• Patricia A. Braski, NP

• Physician Assistant in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.