NICKLAUS M BRADLEY (MD) – Family Medicine Physician, NPI 1942640636

NICKLAUS M BRADLEY (MD) is a healthcare provider. based in Harbor beach, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 4301103808 (MI). The NPI Number for NICKLAUS M BRADLEY (MD) is 1942640636

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
NICKLAUS M BRADLEY (MD)
NPI
1942640636
Phone
(989) 479-3291
Address
8970 SAND BEACH RD
Enumeration Date
27 June 2013
Last Update Date
3 December 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9894793201
Graduation Year
2012 (14 years ago)
PAC ID
6002046109
Group Practice PAC ID
7214903483
Professional Enrollment ID
I20170731002819
Address ID
MI484411236HA210XXSTXX405
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for NICKLAUS M BRADLEY (MD)

  • 8970 SAND BEACH RD

    HARBOR BEACH, MI 484419324

    Phone: (989) 479-3291

    Fax: (989) 479-3365

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $175.

Total Amount is formed as General ($175) + Research ($0) + Ownership ($0) = $175.

Last reported payment date: 2024-12-05 • Largest payer in this snapshot: Exact Sciences Corporation ($59).

Total Amount

$175

General + Research + Ownership

Payments

9

Total payment records

General Amount

$175

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-05

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-07-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170731002819IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48441)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214903483View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineIL
General SurgeryMI
-MI
Family PracticeMI
Emergency MedicineWA
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
U R O L O G YMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

What identifier follows NICKLAUS M BRADLEY (MD) across health systems?
The NPI 1942640636 uniquely identifies NICKLAUS M BRADLEY (MD) in U.S. healthcare data.
Is NICKLAUS M BRADLEY (MD) currently accepting referrals based on NPI status?
Registry metadata lists NICKLAUS M BRADLEY (MD) as active.
What type of care does NICKLAUS M BRADLEY (MD) provide?
NICKLAUS M BRADLEY (MD)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What city is tied to NICKLAUS M BRADLEY (MD)?
The directory associates NICKLAUS M BRADLEY (MD) with Harbor Beach, Michigan. Check all listed addresses for suites or satellite offices.
Can I export NICKLAUS M BRADLEY (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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