Benjamin Tyler Brandt

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5233 Issued in OK

Practice address

19629 NE 23Rd St
Harrah, OK 73045-9305

Phone

(405) 454-0010

Fax

(405) 454-0030

NPI assigned

Sep 30, 2015

Last updated

Sep 28, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Physical Therapy and Rehab Services IncGroup PAC ID 1850370453, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northland Physical Therapy & Rehab Services, Inc

  • Physical Therapist
  • N Kansas City, MO
  • NPI 1740273218

  KS

  Medicare reassignment Care Compare group NPD
• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Leawood, KS
  • NPI 1669421509
  NPD (past)

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1114397312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730450746",
            "telephone_number": "405-454-0010",
            "fax_number": "405-454-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19629 NE 23RD ST",
            "city": "HARRAH",
            "state": "OK",
            "postal_code": "730459305",
            "telephone_number": "405-454-0010",
            "fax_number": "405-454-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "BENJAMIN",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-30",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2015",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Diane Bartlow, PA-C
• Cassandra D Battle, LPN
• Bestyet Healthmart Pharmacy
• Bestyet Pharmacy LLC (Bestyet Healthmart Pharmacy)
• Brendan Keith Biffle, PTA
• Alison Rose Brzozowski
• Hailey D Burch, PHARM D
• Hunter Rayn Carter
• Alyssa Elaine Casey, PHARMD
• Donald Brandt Casey, PHARMD

• Physical Therapist in Harrah, OK
• Providers in Harrah, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.