Brandon Grady, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010429 Issued in MI

Practice address

14671 Telegraph Rd
Redford, MI 48239-3300

Phone

(313) 948-3055

NPI assigned

Mar 24, 2021

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark Alrais MD PC

  • Family Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1114417813
  Medicare reassignment
• Farmington Hills Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Farmington Hills, MI
  • NPI 1144956350
  NPD (past)

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1932785342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14671 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393300",
            "telephone_number": "313-948-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14671 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482393300",
            "telephone_number": "313-948-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "BRANDON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodness Land LLC
• Kimberly Goodson
• Robert Darnell Gordon Sr.
• Torima Gorsuch
• Gracious Corner Agency LLC
• Nikole Lauren Granett, M.A.
• Tara Grant, OTR
• Great Lakes Physicians of Redford,P.L.L.C.
• Greater Grace Health System, Inc.
• Greater Hope Home Healthcare LLC

• Physician Assistant in Redford, MI
• Providers in Redford, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.