NPIMap

Individual provider Active NPI

Bradford Bittner Wylie, MD

  • Internal Medicine Physician
  • Dexter, MI
National Provider Identifier
1750367033
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301067908 Issued in MI
Practice address
7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568
Phone
(734) 426-9028
Fax
(734) 426-9029
NPI assigned
Dec 19, 2005
Last updated
May 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301067908 MI Primary

Addresses

Primary practice location

7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568

Mailing address

24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other identifiers 2

IdentifierTypeStateIssuer
1108127972OtherMIBCBS
459558310MedicaidMI

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
I20040430000110 MI Practitioner - Internal Medicine 7810984804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

7093 Dexter Ann Arbor Rd
Dexter, MI 48130-8568
Phone (734) 426-8696

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Internal Medicine CurrentSince Jun 1, 2020 Accepting new patients
Iha Health Service Corporation CurrentSince Jun 1, 2020 Accepting new patients
Chelsea Community Hospital Past Accepting new patients
Chelsea Area Primary Care PLLC Internal Medicine Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

3200 W Liberty Rd
Ste C
Ann Arbor, MI 48103
Phone (734) 761-2581

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

14650 E Old US Highway 12
Ste 101
Chelsea, MI 48118
Phone (734) 475-3979

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

7093 Dexter Ann Arbor Rd
Dexter, MI 48130
Phone (734) 426-8696

Interoperability endpoints

  • Direct secure messaging: bwylie26251@direct.trinity-health.org

Organizations & group practices 7

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 9

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1750367033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7093 DEXTER ANN ARBOR RD",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308568",
            "telephone_number": "734-426-9028",
            "fax_number": "734-426-9029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLIE",
        "first_name": "BRADFORD",
        "middle_name": "BITTNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301067908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1108127972",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459558310",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, MI

Sources for this page

Verify at the official NPI Registry.